Michael T Robertson, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

30285 Issued in TN

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 539-9582

NPI assigned

Feb 25, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1639763105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "30285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US ARMY",
            "identifier": "1267409290",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cockeysville",
            "affiliation": "N",
            "address_1": "201 Clay Hill Cir",
            "city": "Cockeysville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210301938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ernesto Rivera Jr., FNP
• Raul A. Rivera, MD
• Julie A Rizzo, M.D.
• Danielle Robbins, LCSW
• Michael L. Roberts, DDS
• Natalie Marie Robertson, DPT
• Martin Banks Robinette, AUD CCCA
• David W. Robinson, CRNA
• Nicole Robinson
• Ronnie P Robinson

• Acute Care Nurse Practitioner in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.