Individual provider Active NPI

Robin Whitaker, DO

  • Family Medicine Physician
  • Hazard, KY
National Provider Identifier
1477560605
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02984 Issued in KY
Practice address
210 Black Gold Blvd Ste 106
Hazard, KY 41701-2620
Phone
(606) 436-0711
Fax
(606) 435-1322
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02984 KY Primary

Addresses

Primary practice location

210 Black Gold Blvd Ste 106
Hazard, KY 41701-2620

Mailing address

PO Box 959
Hazard, KY 41702-0959
Phone (606) 436-0711

Other identifiers 1

IdentifierTypeStateIssuer
64130230MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061013000000 KY Practitioner - Family Practice 2769467091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Mountain Health Alliance, Inc.Group PAC ID 8123112687, 20 clinicians

Practice addresses (Care Compare)

210 Black Gold Blvd
Suite 106
Hazard, KY 41701-2620
Phone (606) 436-0711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1588TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mountain Health Alliance, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Mountain After Hours Clinic PSC CurrentSince Aug 1, 2022 Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients
Frontier Nursing Healthcare Family Medicine Past Accepting new patients

Locations

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

279 E Main St
Hazard, KY 41701
Phone (606) 487-9505

1908 N Main St
Ste 120
Hazard, KY 41701

210 Black Gold Blvd
Ste 106
Hazard, KY 41701
Phone (606) 436-0711

210 Black Gold Blvd
Hazard, KY 41701
Phone (606) 436-0711

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: robin.whitaker.p1@direct.kymha.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AIEDDD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1477560605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417020959",
            "telephone_number": "606-436-0711",
            "fax_number": "606-435-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BLACK GOLD BLVD STE 106",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012620",
            "telephone_number": "606-436-0711",
            "fax_number": "606-435-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "ROBIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64130230",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.