Kevin C Robertson, AT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2105 Issued in OH

Practice address

9930 Johnnycake Ridge Rd
Suite 6B
Mentor, OH 44060-6752

Phone

(440) 357-6677

Fax

(440) 357-6681

NPI assigned

Jun 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Agm Physical Therapy, LLC

  • Specialist
  • Mentor, OH
  • NPI 1689691776
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477757904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 S MERLYN PL",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779533",
            "telephone_number": "440-357-6677",
            "fax_number": "440-357-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 JOHNNYCAKE RIDGE RD",
            "address_2": "SUITE 6B",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606752",
            "telephone_number": "440-357-6677",
            "fax_number": "440-357-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KEVIN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "AT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT2105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Ritchey, NP-C
• Rite Aid of Ohio Inc (Rite Aid Pharmacy 03174)
• Rite Aid Pharmacy
• Christina M Rivera
• Kayla Rivera
• Carol Robinson
• Christine Robinson, LISW
• Michele Robinson
• Sara Beth Robinson
• Yalonda Robinson

• Athletic Trainer in Mentor, OH
• Providers in Mentor, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.