Individual provider Active NPI

Robert Douglass Barnes, MD

  • Pediatrics Physician
  • New Haven, IN
National Provider Identifier
1629008024
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01026191A Issued in 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
Last updated
Jun 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01026191A IN Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000186 IN Practitioner - Pediatric Medicine 3274729728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01026191AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Medical Group Inc CurrentSince Nov 1, 2010 Accepting new patients
St Joseph Medical Group Inc Pediatrics CurrentSince Nov 1, 2010 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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1629008024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 MINNICH RD",
            "address_2": "SUITE 4",
            "city": "NEW HAVEN",
            "state": "IN",
            "postal_code": "467742052",
            "telephone_number": "260-493-6508",
            "fax_number": "260-493-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 MINNICH RD",
            "address_2": "SUITE 4",
            "city": "NEW HAVEN",
            "state": "IN",
            "postal_code": "467742052",
            "telephone_number": "260-493-6508",
            "fax_number": "260-493-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "ROBERT",
        "middle_name": "DOUGLASS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01026191A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, IN

Sources for this page

Verify at the official NPI Registry.