Active NPI
Carly Beverly Robertson, LM
- Midwife
- Taylor, TX
National Provider Identifier
1609332352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 99363
- Practice address
- 1411 Gilmore St
Taylor, TX 76574-1405 - Phone
- (512) 731-9474
- Fax
- (512) 352-0031
- NPI assigned
- Feb 19, 2019
- Last updated
- Feb 19, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 99363 | TX | Primary |
Addresses
Primary practice location
1411 Gilmore St
Taylor, TX 76574-1405
Mailing address
1411 Gilmore St
Taylor, TX 76574-1405
Phone (512) 731-9474
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
| License | State | Type | Specialty |
|---|---|---|---|
| 99363 | TX | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1609332352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 GILMORE ST",
"city": "TAYLOR",
"state": "TX",
"postal_code": "765741405",
"telephone_number": "512-731-9474",
"fax_number": "512-352-0031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 GILMORE ST",
"city": "TAYLOR",
"state": "TX",
"postal_code": "765741405",
"telephone_number": "512-731-9474",
"fax_number": "512-352-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "CARLY",
"middle_name": "BEVERLY",
"credential": "LM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "TX",
"license": "99363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylor, TX
- R and N Vision LLC Dba Optical Design
- Anthony Rabaey, MAT LAT ATC
- Juan Carlos Razo, M.D.
- Divya Reddy
- River City Wellness 2
- Kellye Rayann Roper, FNP-BC
- Samdumu International LLC (Taylor Area Pharmacy)
- Virginia K. Schooler, RD
- John A. Schuchmann, M.D.
- Scott & White Hospital - Taylor (Baylor Scott & White Medical Center - Taylor)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.