Active NPI
Gerald Robinson
- Mental Health Counselor
- Fort Dodge, IA
National Provider Identifier
1467835280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 078315
- Practice address
- 720 Kenyon Rd
Fort Dodge, IA 50501-5759 - Phone
- (515) 955-7171
- NPI assigned
- Jun 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20001 | IA | |
| Mental Health Counselor | 101YM0800X | 078315 | IA | Primary |
Addresses
Primary practice location
720 Kenyon Rd
Fort Dodge, IA 50501-5759
Mailing address
720 Kenyon Rd
Fort Dodge, IA 50501-5759
Phone (515) 955-7171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0159608 | Medicaid | IA | |
| 07466 | Other | WELLMARK BC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20001 | IA | MD | Addiction (Substance Use Disorder) Counselor |
| 078315 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1467835280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015759",
"telephone_number": "515-955-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015759",
"telephone_number": "515-955-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "GERALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-30",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "20001",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "078315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0159608",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC",
"identifier": "07466",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.