Individual provider Active NPI

Robert W Daniels, PHD

  • Psychologist
  • Sandusky, OH
National Provider Identifier
1336138940
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
587 Issued in OH
Practice address
1617 W Bogart Rd
Suite 5
Sandusky, OH 44870-5787
Phone
(419) 626-8226
Fax
(419) 621-0457
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 587 OH Primary

Addresses

Primary practice location

1617 W Bogart Rd
Suite 5
Sandusky, OH 44870-5787

Mailing address

1617 W Bogart Rd
Suite 5
Sandusky, OH 44870-5787
Phone (419) 626-8226

Other identifiers 2

IdentifierTypeStateIssuer
000000130921OtherANTHEM
34135671800OtherOHBUREAU OF WORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
587OHMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Firelands Regional Medical Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1336138940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 W BOGART RD",
            "address_2": "SUITE 5",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705787",
            "telephone_number": "419-626-8226",
            "fax_number": "419-621-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 W BOGART RD",
            "address_2": "SUITE 5",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705787",
            "telephone_number": "419-626-8226",
            "fax_number": "419-621-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000130921",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF WORKERS COMP",
            "identifier": "34135671800",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.