Brent Farr Robertson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

168260-1205 Issued in UT

Practice address

1321 E South Temple
5
Salt Lake City, UT 84102-1830

Phone

(801) 643-5809

NPI assigned

Feb 14, 2012

Sex

Male

Sole proprietor

Yes

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

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1437422995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 E SOUTH TEMPLE",
            "address_2": "5",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021830",
            "telephone_number": "801-643-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 E SOUTH TEMPLE",
            "address_2": "5",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021830",
            "telephone_number": "801-643-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "BRENT",
        "middle_name": "FARR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "168260-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley McHilton Roberts, DO
• Zoe A Roberts, CMHC
• Vincent Robertsa Jimenez
• Andrew Robertson, PA-C
• Bradley Robertson
• Desa-Rae Patrice Robertson
• Emily Robertson
• Heather Patricia Robertson, PTA
• Jared Christian Robertson II
• Joan U Robertson

• Specialist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.