Organization Active NPI

Jerome a Robson M D Inc

  • Anesthesiology Physician
  • Modesto, CA
National Provider Identifier
1447589353
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G32736 Issued in CA
Legal business name
JEROME A ROBSON M D INC
Practice address
500 Coffee Road
Suite E
Modesto, CA 95355-4241
Phone
(209) 521-1209
Fax
(209) 521-1215
NPI assigned
Dec 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Jerome Anthony Robson, MD
Title
President
Phone
(209) 529-9603

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X G32736 CA Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X G32736 CA

Addresses

Primary practice location

500 Coffee Road
Suite E
Modesto, CA 95355-4241

Mailing address

817 Coffee Rd
Building C3
Modesto, CA 95355-4241
Phone (209) 529-9603

Other identifiers 1

IdentifierTypeStateIssuer
OOG327360MedicaidCA

National Provider Directory

National Provider Directory

Locations

500 Coffee Rd
Ste E
Modesto, CA 95355
Phone (209) 521-1209

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1447589353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COFFEE RD",
            "address_2": "BUILDING C3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554241",
            "telephone_number": "209-529-9603",
            "fax_number": "209-529-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COFFEE ROAD",
            "address_2": "SUITE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554241",
            "telephone_number": "209-521-1209",
            "fax_number": "209-521-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME A ROBSON M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "ROBSON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-529-9603",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G32736",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G32736",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG327360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.