NPIMap

Organization Active NPI

Robert N Israel, MD

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1861622169
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301052400 Issued in MI
Legal business name
ROBERT N ISRAEL, MD
Practice address
124 Seymour Ave
Jackson, MI 49202-3558
Phone
(517) 782-5700
Fax
(517) 782-3141
NPI assigned
Jul 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Authorized official

Name
Dr. Robert Nathan Israel, MDNPI 1083688261
Title
Owner
Phone
(517) 782-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4301052400 MI Primary

Addresses

Primary practice location

124 Seymour Ave
Jackson, MI 49202-3558

Mailing address

124 Seymour Ave
Jackson, MI 49202-3558
Phone (517) 782-5700

Other identifiers 2

IdentifierTypeStateIssuer
2602310 TYPE 10MedicaidMI
0381629OtherBLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

Locations

124 Seymour Ave
Jackson, MI 49202
Phone (517) 782-5700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1861622169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SEYMOUR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023558",
            "telephone_number": "517-782-5700",
            "fax_number": "517-782-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SEYMOUR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023558",
            "telephone_number": "517-782-5700",
            "fax_number": "517-782-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT N ISRAEL, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-782-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301052400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2602310 TYPE 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0381629",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.