Robert Deters, MD, Interventional Pain Management

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ROBERT DETERS, MD, INTERVENTIONAL PAIN MANAGEMENT

Practice address

50 Memorial Dr
Suite 207
Leominster, MA 01453-2238

Phone

(978) 466-2121

Fax

(978) 466-2274

NPI assigned

Dec 1, 2008

Organization subpart

Yes

Parent organization

COORDINATED PRIMARY CAREAs reported in NPPES

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

Authorized official

Name

Phyllis Fabello

Title

Executive Director

Phone

(978) 466-4243

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Coordinated Primary Care Inc

Locations

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1699920850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 207",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-466-2121",
            "fax_number": "978-466-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 207",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-466-2121",
            "fax_number": "978-466-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT DETERS, MD, INTERVENTIONAL PAIN MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COORDINATED PRIMARY CARE",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "FABELLO",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-466-4243"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9771476",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Marili Rivera
• RMX Monitoring LLC.
• Jacqueline Robar, BS
• Elizabeth Robbins
• Jonathan Harris Robbins, M.D.
• Robert M Trudel SCD PC
• Patricia A Roberts, LADC
• Martha J Robillard, OTRL
• Kim M Robles, MA, LMHC, BC-DMT
• Dionyssios A. Robotis, M.D.

• Physical Medicine & Rehabilitation Physician in Leominster, MA
• Providers in Leominster, MA by specialty
• Physical Medicine & Rehabilitation Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.