NPIMap

Organization Active NPI

Robert Stetson, MD, PLLC

  • Psychiatry Physician
  • Cleveland, TN
National Provider Identifier
1326228602
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ROBERT STETSON, MD, PLLC
Practice address
2650 Executive Park NW
Suite #3
Cleveland, TN 37312-2746
Phone
(423) 473-2633
Fax
(423) 473-2643
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Allan Stetson Jr., M.D.NPI 1891729927
Title
President
Phone
(423) 473-2633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X TN Primary
Adult Mental Health Clinic/Center 261QM0850X 42758 TN

Addresses

Primary practice location

2650 Executive Park NW
Suite #3
Cleveland, TN 37312-2746

Mailing address

2650 Executive Park NW
Suite #3
Cleveland, TN 37312-2746
Phone (423) 473-2633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071211000108 TN Part B Supplier - Clinic/Group Practice 3072602291 Receives reassigned benefits from 1 practitioner
Practice locations: Cleveland, TN

National Provider Directory

National Provider Directory

Locations

2650 Executive Park NW
Ste 3
Cleveland, TN 37312
Phone (423) 473-2633

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1326228602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 EXECUTIVE PARK NW",
            "address_2": "SUITE #3",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122746",
            "telephone_number": "423-473-2633",
            "fax_number": "423-473-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 EXECUTIVE PARK NW",
            "address_2": "SUITE #3",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122746",
            "telephone_number": "423-473-2633",
            "fax_number": "423-473-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT STETSON, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "STETSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-473-2633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TN",
            "license": "42758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.