Robert Douglass Barnes, MD
Individual provider Active NPI Pediatrics Physician · New Haven, IN
NPI 1629008024 · NPPES record last updated Jun 15, 2012
Key facts
- NPI
- 1629008024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01026191A (IN)
- Practice address
- 1302 Minnich Rd
Suite 4
New Haven, IN 46774-2052 - Phone
- (260) 493-6508
- Fax
- (260) 493-6509
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101123000186 | IN | Practitioner - Pediatric Medicine | 3274729728 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01026191A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| St Joseph Medical Group Inc | Current |
Accepting new patients |
Locations
800 Broadway
Ste 204
Fort Wayne, IN 46802
Phone (260) 420-4884
1302 Minnich Rd
Ste D
New Haven, IN 46774
Phone (260) 425-2614
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01026191A | IN | Yes |
Addresses
Primary practice location
1302 Minnich Rd
Suite 4
New Haven, IN 46774-2052
Mailing address
1302 Minnich Rd
Suite 4
New Haven, IN 46774-2052
Phone (260) 493-6508
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100054870 | Medicaid | IN |
Other providers in New Haven, IN
- Advanced Alarms
- Logan D Anderson
- Edem Y Atakey
- David Baker
- Thomas Eugene Baker I
- Bet Hashem Midrash
- Emily Blake
- Andrea Boley
- Thomas W. Bond
- Susan L Bosler
All providers in New Haven, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.