Individual provider Active NPI

Robin Deardorff

  • Contractor
  • Spring Mills, PA
National Provider Identifier
1568812956
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
OC001766L Issued in PA
Practice address
664 Lower Georges Valley Rd
Spring Mills, PA 16875-8201
Phone
(814) 422-8281
NPI assigned
Jun 15, 2016
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X OC001766L PA Primary

Addresses

Primary practice location

664 Lower Georges Valley Rd
Spring Mills, PA 16875-8201

Mailing address

664 Lower Georges Valley Rd
Spring Mills, PA 16875-8201
Phone (814) 422-8281

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OC001766LPAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1568812956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 LOWER GEORGES VALLEY RD",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168758201",
            "telephone_number": "814-422-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 LOWER GEORGES VALLEY RD",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168758201",
            "telephone_number": "814-422-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARDORFF",
        "first_name": "ROBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "PA",
            "license": "OC001766L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Mills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.