Robert B Dehgan M D P a

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME16903 Issued in FL

Legal business name

ROBERT B DEHGAN M D P A

Practice address

1 Orthopaedic PL
St Augustine, FL 32086-4202

Phone

(904) 247-1919

Fax

(904) 246-0301

NPI assigned

Apr 11, 2008

Organization subpart

No

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

Authorized official

Name

Robert B Dehgan, MD

Title

Ceo/Owner

Phone

(904) 247-1919

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1700059623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OSCEOLA AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504078",
            "telephone_number": "904-247-1919",
            "fax_number": "904-246-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORTHOPAEDIC PL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864202",
            "telephone_number": "904-247-1919",
            "fax_number": "904-246-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B DEHGAN M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "DEHGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "904-247-1919",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME16903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049429100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "250011286",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.