Individual provider Active NPI

Robert Colin McNamara, MD

  • General Practice Physician
  • Niceville, FL
National Provider Identifier
1710629621
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101279252 Issued in VA
Practice address
8840 Range Rd
Niceville, FL 32578-8729
Phone
(850) 882-8370
NPI assigned
Apr 11, 2022
Last updated
May 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
General Practice Physician 208D00000X 0101279252 VA Primary
Military Health Care Provider 171000000X NU

Addresses

Primary practice location

8840 Range Rd
Niceville, FL 32578-8729

Mailing address

8840 Range Rd
Niceville, FL 32578-8729

Other identifiers 1

IdentifierTypeStateIssuer
0101279252OtherVAUNRESTRICTED MEDICAL LICENSE NUMBER

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101279252VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1710629621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 RANGE RD",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 RANGE RD",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788729",
            "telephone_number": "850-882-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAMARA",
        "first_name": "ROBERT",
        "middle_name": "COLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101279252",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNRESTRICTED MEDICAL LICENSE NUMBER",
            "identifier": "0101279252",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; 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.