Individual provider Active NPI

Katelyn Robson

  • Physician Assistant
  • Eglin Afb, FL
National Provider Identifier
1427525195
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111552 Issued in FL
Practice address
340 Boatner Rd
Eglin Afb, FL 32542-1391
Phone
(850) 883-8600
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9111552 FL Primary

Addresses

Primary practice location

340 Boatner Rd
Eglin Afb, FL 32542-1391

Mailing address

340 Boatner Rd
Eglin Afb, FL 32542-1391
Phone (850) 883-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021001341 FL Order and Referring Only - UrologyPractitioner - Urology 9830430552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9111552FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Internal Medicine LLC PastSince May 25, 2021 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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1427525195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBSON",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.