NPIMap

Organization Active NPI

Philip B Robertson M.D.

Doing business as psychiatric associates of the virginias

  • Psychiatry Physician
  • Bluefield, VA
National Provider Identifier
1457369100
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PHILIP B ROBERTSON M.D.
Doing business as
psychiatric associates of the virginias
Practice address
105 Westwood Commons
Bluefield, VA 24605-2009
Phone
(276) 326-2686
Fax
(276) 326-2249
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Dr. Philip Brunner Robertson, M.D.
Title
Psychiatrist
Phone
(276) 326-2686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

105 Westwood Commons
Bluefield, VA 24605-2009

Mailing address

347 Sandpiper Ave
Princeton, WV 24740-4185
Phone (304) 425-2620

Other identifiers 2

IdentifierTypeStateIssuer
0114647000MedicaidWV
7107340MedicaidVA

Other names 1

  • psychiatric associates of the virginias Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1457369100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 SANDPIPER AVE",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247404185",
            "telephone_number": "304-425-2620",
            "fax_number": "276-326-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WESTWOOD COMMONS",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246052009",
            "telephone_number": "276-326-2686",
            "fax_number": "276-326-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP B ROBERTSON M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "BRUNNER",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "276-326-2686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114647000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7107340",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "psychiatric associates of the virginias",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluefield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.