Individual provider Active NPI

Robert Paul McMinn, CRNP, FNP-C

  • Family Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1548741010
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP019108 Issued in PA
Practice address
1 Freedom Way
Augusta, GA 30904
Phone
(706) 733-1088
NPI assigned
Aug 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP019108 PA Primary

Addresses

Primary practice location

1 Freedom Way
Augusta, GA 30904

Mailing address

1 Freedom Way
Augusta, GA 30904
Phone (706) 733-1088

Other practice location 1

1425 Eden Rd
York, PA 17402-1907
Phone (717) 852-6574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240427001887 TX Practitioner - Nurse Practitioner 8527408384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP019108PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1548741010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30904",
            "telephone_number": "706-733-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30904",
            "telephone_number": "706-733-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Eden Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174021907",
            "country_code": "US",
            "telephone_number": "717-852-6574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMINN",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "credential": "CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.