Individual provider Active NPI

Gina Ann Robertson, ARNP

  • Nurse Practitioner
  • Topeka, KS
National Provider Identifier
1871742817
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
56529 Issued in KS
Practice address
3707 SW 6TH Ave
Topeka, KS 66606-2084
Phone
(785) 270-4630
Fax
(785) 270-4628
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X 74637 KS
Nurse Practitioner 363L00000X 56529 KS Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 74637 KS

Addresses

Primary practice location

3707 SW 6TH Ave
Topeka, KS 66606-2084

Mailing address

3707 SW 6TH Ave
Topeka, KS 66606-2084
Phone (785) 270-4630

Other identifiers 2

IdentifierTypeStateIssuer
200738650BMedicaidKS
100385900AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170321000897 KS Practitioner - Nurse Practitioner 1153606876 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
56529KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Feb 16, 2017 Accepting new patients
Cotton O'Neil Clinic Recovable Trust CurrentSince Feb 16, 2017 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust Current Accepting new patients
Astra Mental Health and Recovery, Inc. Past Accepting new patients
Florence Crittenton Services of Topeka, Inc. Past Accepting new patients

Locations

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

3707 SW 6th Ave
Topeka, KS 66606
Phone (785) 270-4630

901 SW Garfield Ave
Topeka, KS 66606

Interoperability endpoints

  • Direct secure messaging: grobertson13007@stormontvaildirect.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1871742817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 SW 6TH AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666062084",
            "telephone_number": "785-270-4630",
            "fax_number": "785-270-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 SW 6TH AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666062084",
            "telephone_number": "785-270-4630",
            "fax_number": "785-270-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GINA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "KS",
            "license": "74637",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "56529",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "74637",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200738650B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100385900A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.