Individual provider Active NPI

Payne Andrew Robertson

  • Rehabilitation Practitioner
  • East Lansing, MI
National Provider Identifier
1730636184
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
1230 Haslett Rd
Apt A15
East Lansing, MI 48823-2869
Phone
(734) 660-1072
NPI assigned
Sep 1, 2016
Reactivated
Jul 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

1230 Haslett Rd
Apt A15
East Lansing, MI 48823-2869

Mailing address

1230 Haslett Rd
Apt A15
East Lansing, MI 48823-2869
Phone (734) 660-1072

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1730636184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 HASLETT RD",
            "address_2": "APT A15",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232869",
            "telephone_number": "734-660-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 HASLETT RD",
            "address_2": "APT A15",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232869",
            "telephone_number": "734-660-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "PAYNE",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-07-21",
        "deactivation_date": "2017-08-18",
        "reactivation_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.