Active NPI
David R Robertson Jr., DPT
- Physical Therapist
- Fayetteville, TN
National Provider Identifier
1508047663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7961
- Practice address
- 501 Amana Ave
Fayetteville, TN 37334-3365 - Phone
- (931) 433-7156
- NPI assigned
- Nov 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7961 | TN | Primary |
Addresses
Primary practice location
501 Amana Ave
Fayetteville, TN 37334-3365
Mailing address
18306 Crowne Brook Cir
Franklin, TN 37067-1678
Phone (706) 766-3632
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7961 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1508047663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18306 CROWNE BROOK CIR",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370671678",
"telephone_number": "706-766-3632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 AMANA AVE",
"city": "FAYETTEVILLE",
"state": "TN",
"postal_code": "373343365",
"telephone_number": "931-433-7156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-16",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "7961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.