Active NPI
Kerstin Lee Robinette, PH.D.
- Clinical Psychologist
- Broken Arrow, OK
National Provider Identifier
1366469702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 843
- Practice address
- 112 W Kenosha St
Broken Arrow, OK 74012-8901 - Phone
- (918) 259-1118
- Fax
- (918) 259-3507
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 843 | OK | Primary |
Addresses
Primary practice location
112 W Kenosha St
Broken Arrow, OK 74012-8901
Mailing address
PO Box 1444
Broken Arrow, OK 74013-1444
Phone (918) 259-1118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100842830A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071005000288 | OK | Practitioner - Clinical Psychologist | 1658466636 | Practice locations: Broken Arrow, OK |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Texas Tech University Health Science Center School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
308 N Aspen Ave
Broken Arrow, OK 74012-2228
Phone (918) 259-1118
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 843 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1366469702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1444",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740131444",
"telephone_number": "918-259-1118",
"fax_number": "918-259-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 W KENOSHA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740128901",
"telephone_number": "918-259-1118",
"fax_number": "918-259-3507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINETTE",
"first_name": "KERSTIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2022-02-11",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OK",
"license": "843",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100842830A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.