Active NPI
Carlie R Robertson
- Registered Dietitian
- Bessemer, AL
National Provider Identifier
1720480353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2479
- Practice address
- 995 9TH Ave SW
Bessemer, AL 35022-4527 - Phone
- (205) 481-7122
- Fax
- (205) 481-8435
- NPI assigned
- Sep 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2479 | AL | Primary |
Addresses
Primary practice location
995 9TH Ave SW
Bessemer, AL 35022-4527
Mailing address
995 9TH Ave SW
Bessemer, AL 35022-4527
Phone (205) 481-7122
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2479 | AL | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411689600000",
"number": "1720480353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 9TH AVE SW",
"city": "BESSEMER",
"state": "AL",
"postal_code": "350224527",
"telephone_number": "205-481-7122",
"fax_number": "205-481-8435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "995 9TH AVE SW",
"city": "BESSEMER",
"state": "AL",
"postal_code": "350224527",
"telephone_number": "205-481-7122",
"fax_number": "205-481-8435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "CARLIE",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-26",
"last_updated": "2014-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "2479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bessemer, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.