Individual provider Active NPI

Robert Clayton Jarchow, MEDICAL DOCTOR

  • Facial Plastic Surgery Physician
  • Concord, NC
National Provider Identifier
1629114137
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
39284 Issued in NC
Practice address
1018 Lee Ann Dr NE
Concord, NC 28025-2911
Phone
(704) 782-7111
Fax
(704) 782-7139
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 39284 NC Primary

Addresses

Primary practice location

1018 Lee Ann Dr NE
Concord, NC 28025-2911

Mailing address

1018 Lee Ann Dr NE
Concord, NC 28025-2911
Phone (704) 782-7111

Other identifiers 1

IdentifierTypeStateIssuer
890183RMedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1629114137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-7111",
            "fax_number": "704-782-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-7111",
            "fax_number": "704-782-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARCHOW",
        "first_name": "ROBERT",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NC",
            "license": "39284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890183R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.