Active NPI
Robert W Daniels, PHD
- Psychologist
- Sandusky, OH
National Provider Identifier
1336138940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 587
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000130921 | Other | ANTHEM | |
| 34135671800 | Other | OH | BUREAU 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.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 587 | OH | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Acute Care Hospital
- Sandusky, OH
- NPI 1285392936
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.