Shervon Stoutamire Robinson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-02508 Issued in NC

Practice address

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468

Phone

(704) 749-5800

Fax

(704) 749-5819

NPI assigned

Dec 3, 2010

Last updated

Nov 28, 2012By the provider in NPPES

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Anesthesiology Associates, P.a.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1396739884
  Medicare reassignment
• Pain and Orthopedic Neurology, PA

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Charlotte, NC
  • NPI 1083631824
  NPD (past)

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1467754978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SHERVON",
        "middle_name": "STOUTAMIRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00986388",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "164W4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quiana Robinson, D.D.S
• Rachel Robinson
• Rachel Lillian Robinson
• Ramonica Yvonne Robinson, RN
• Robert Carl Robinson III, M.D.
• Stacey C. Robinson, M.E.D., CCC-SLP
• Stephen Lee Robinson, LPCS LCAS
• T'Maya Robinson, MSW, LCSWA
• Tatiana Zanita Robinson, LMBT
• Taylor James Robinson, PA-C

• Medical Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Medical Physician Assistant in North Carolina

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