Robyn Dettmar, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001894 Issued in IL

Practice address

1601 Monte Vista Ave
190
Claremont, CA 91711-2962

Phone

(909) 865-9977

Fax

(909) 946-0122

NPI assigned

Jun 10, 2005

Last updated

Dec 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• DRS Pichet & Meechai

  • Internal Medicine Physician
  • Red Bud, IL
  • NPI 1417058777
  NPD (past)
• Geriatric and Primary Care Services S C

  • Geriatric Medicine (Internal Medicine) Physician
  • Marion, IL
  • NPI 1174535900
  NPD (past)
• Red Bud Clinic Corp

  • Family Medicine Physician
  • Red Bud, IL
  • NPI 1083617609
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1417951096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MONTE VISTA AVE",
            "address_2": "190",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112962",
            "telephone_number": "909-865-9977",
            "fax_number": "909-946-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MONTE VISTA AVE",
            "address_2": "190",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112962",
            "telephone_number": "909-865-9977",
            "fax_number": "909-946-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMAR",
        "first_name": "ROBYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Belinda Abigail Del Rosario Jimenez, OT
• Dora Leticia Delcid
• Edward M Deng, PHARM.D.
• Nicole Depaola, OTR/L
• Destiny Recovery Inc (Hathaway Recovery)
• William R Devery
• Heather Devine, IMF
• Rianna Devine
• Skyler Edward Gerard Di Ioli
• Chaye' A Dialo, PSYD

• Physician Assistant in Claremont, CA
• Providers in Claremont, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.