Mary Rose Robertson, ARNP-C MSN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP9253787 Issued in FL

Practice address

900 Ingraham Ave
Haines City, FL 33844-4336

Phone

(863) 421-6565

Fax

(863) 421-7474

NPI assigned

Jul 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.robertson@railroadparkpediatrics.directbygreenway.com

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.

• Daniel R. Renuart, M.D., P.a.

  dba Railroad Park Pediatrics and Four Corners Pediatrics

  • Pediatrics Physician
  • Haines City, FL
  • NPI 1346206935
  NPD (past)
• Messieh Orthopedic Clinic PA

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Winter Haven, FL
  • NPI 1972718450
  NPD (past)

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1467682310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MARY",
        "middle_name": "ROSE",
        "name_prefix": "Miss",
        "credential": "ARNP-C MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9253787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "ARNP9253787",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "CW952Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC8324",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yazmin Rivera, BA
• Yvette Rivera
• Ryan Michael Rizk
• Road Opener Group LLC
• Mona Arthurene Roberts
• Annette Robles
• Crystal Joy Rodgers
• Neshenie Rodriguez Arce, DC
• Ana Maria Rodriguez, D.M.D.
• Michelle Rodriguez, CBHCM-S. 100674

• Nurse Practitioner in Haines City, FL
• Providers in Haines City, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.