Active NPI
Paul Ewald Rober, M.D.
- Urology Physician
- Lexington, KY
National Provider Identifier
1518968619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 47817
- 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, 2019
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100377700A | Medicaid | IN | |
| 7100355520 | Medicaid | KY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| TP079 | KY | MD | Neonatal-Perinatal Medicine Physician |
| 47817 | KY | MD | Urology Physician |
Interoperability endpoints
- 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.