Individual provider Active NPI

Paul Ewald Rober, M.D.

  • Urology Physician
  • Lexington, KY
National Provider Identifier
1518968619
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
47817 Issued in KY
Practice address
211 Fountain CT Ste 230
Lexington, KY 40509-2696
Phone
(859) 929-7200
Fax
(859) 629-7212
NPI assigned
Aug 10, 2005
Reactivated
Apr 3, 2006
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01041942 IN
Urology Physician 208800000X 47817 KY Primary

Addresses

Primary practice location

211 Fountain CT Ste 230
Lexington, KY 40509-2696

Mailing address

PO Box 936
London, KY 40743-0936

Other identifiers 2

IdentifierTypeStateIssuer
100377700AMedicaidIN
7100355520MedicaidKY

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TP079KYMDNeonatal-Perinatal Medicine Physician
47817KYMDUrology Physician

Interoperability endpoints

  • Direct secure messaging: prober274956@direct.stlukeshealth.org

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1518968619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FOUNTAIN CT STE 230",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092696",
            "telephone_number": "859-929-7200",
            "fax_number": "859-629-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBER",
        "first_name": "PAUL",
        "middle_name": "EWALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-07-11",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01041942",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "47817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100377700A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100355520",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.