Individual provider Active NPI

Robert A Maines, RN

  • Administrator Registered Nurse
  • Lafayette, IN
National Provider Identifier
1720387921
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
28168982A Issued in IN
Practice address
1013 N 13TH St
Lafayette, IN 47904-2011
Phone
(765) 428-8888
Fax
(765) 428-8889
NPI assigned
Mar 28, 2011
Last updated
Mar 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 28168982A IN Primary
Critical Care Medicine Registered Nurse 163WC0200X 28168982A IN
Emergency Registered Nurse 163WE0003X 28168982A IN
Ophthalmic Registered Nurse 163WX1100X 28168982A IN

Addresses

Primary practice location

1013 N 13TH St
Lafayette, IN 47904-2011

Mailing address

4252 E 100 S Apt 3
Kokomo, IN 46902-9129
Phone (765) 428-8888

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28168982AINMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lafayette Retina Center, P.C. PastSince Aug 2, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1720387921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4252 E 100 S APT 3",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469029129",
            "telephone_number": "765-428-8888",
            "fax_number": "765-428-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 N 13TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042011",
            "telephone_number": "765-428-8888",
            "fax_number": "765-428-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINES",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IN",
            "license": "28168982A",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IN",
            "license": "28168982A",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28168982A",
            "primary": false
        },
        {
            "code": "163WX1100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ophthalmic",
            "state": "IN",
            "license": "28168982A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.