Individual provider Active NPI

Robert Kent Levy, MD

  • Internal Medicine Physician
  • Coos Bay, OR
National Provider Identifier
1447234018
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD13347 Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-0000
Phone
(541) 267-5151
Fax
(541) 266-4501
NPI assigned
Dec 6, 2005
Last updated
Oct 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13347 OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-0000

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-0000
Phone (541) 267-5151

Other identifiers 5

IdentifierTypeStateIssuer
110195355OtherORRR MEDICARE PTAN NUMBER
R0000WFBTVOtherORMEDICARE GROUP PIN NUMBER
278044MedicaidOR
1407812365OtherORNBMC NPI NUMBER-GROUP
CD8723OtherORRR MEDICARE GROUP NUMBER

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD13347ORMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1447234018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200000",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200000",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "ROBERT",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD13347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "110195355",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278044",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC NPI NUMBER-GROUP",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CD8723",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.