Individual provider Active NPI

Deborah H. Robertson, APRN, BC, FNP

  • Family Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1619164340
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
078236 Issued in MO
Practice address
#1 Hosp Dr MC-11, Dco92.10
Columbia, MO 65212-0001
Phone
(573) 884-9924
Fax
(573) 884-5735
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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 078236 MO Primary

Addresses

Primary practice location

#1 Hosp Dr MC-11, Dco92.10
Columbia, MO 65212-0001

Mailing address

4401 Thornbrook Ter
Columbia, MO 65203-9741
Phone (573) 234-1341

Other identifiers 1

IdentifierTypeStateIssuer
078236OtherMOAPRN, BC, FNP

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
078236MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1619164340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 THORNBROOK TER",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039741",
            "telephone_number": "573-234-1341",
            "fax_number": "573-884-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 HOSP DR MC-11, DCO92.10",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-884-9924",
            "fax_number": "573-884-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "DEBORAH",
        "middle_name": "H.",
        "name_prefix": "Ms.",
        "credential": "APRN, BC, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "078236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN, BC, FNP",
            "identifier": "078236",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.