Individual provider Active NPI

Robert Robertson, PHARMACIST

  • Pharmacist
  • Augusta, GA
National Provider Identifier
1790109965
Registry record updated Feb 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH027639 Issued in GA
Practice address
235 Robt Danel Jr Pkwy
Store #1090
Augusta, GA 30909-0800
Phone
(706) 733-3011
NPI assigned
Feb 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH027639 GA Primary

Addresses

Primary practice location

235 Robt Danel Jr Pkwy
Store #1090
Augusta, GA 30909-0800

Mailing address

235 Robt Danel Jr Pkwy
Store #1090
Augusta, GA 30909-0800
Phone (706) 733-3011

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

LicenseStateTypeSpecialty
RPH027639GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391904000000",
    "number": "1790109965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 ROBT DANEL JR PKWY",
            "address_2": "STORE #1090",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309090800",
            "telephone_number": "706-733-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 ROBT DANEL JR PKWY",
            "address_2": "STORE #1090",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309090800",
            "telephone_number": "706-733-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "ROBERT",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-09",
        "last_updated": "2014-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH027639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.