Individual provider Active NPI

Robert Charles Ivy, RN

  • Home Health Registered Nurse
  • Palm Desert, CA
National Provider Identifier
1396604120
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
95320076 Issued in CA
Practice address
78000 Fred Waring Dr
Palm Desert, CA 92211-9266
Phone
(888) 415-8015
NPI assigned
Jan 19, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 95320076 CA Primary

Addresses

Primary practice location

78000 Fred Waring Dr
Palm Desert, CA 92211-9266

Mailing address

78000 Fred Waring Dr
Palm Desert, CA 92211-9266
Phone (888) 415-8015

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95320076CAMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1768780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1396604120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78000 FRED WARING DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922119266",
            "telephone_number": "888-415-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78000 FRED WARING DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922119266",
            "telephone_number": "888-415-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "95320076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; 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.