Active NPI
Ischaji Nyerere Robertson, PSY.D.
- Clinical Psychologist
- Miami, FL
National Provider Identifier
1881837276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY6163
- Practice address
- 15321 S Dixie Hwy
Suite 303a
Miami, FL 33157-1814 - Phone
- (786) 586-3818
- NPI assigned
- Apr 14, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY6163 | FL | Primary |
Addresses
Primary practice location
15321 S Dixie Hwy
Suite 303a
Miami, FL 33157-1814
Mailing address
15321 S Dixie Hwy
Suite 303a
Miami, FL 33157-1814
Phone (786) 586-3818
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6163 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239667200000",
"number": "1881837276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15321 S DIXIE HWY",
"address_2": "SUITE 303A",
"city": "MIAMI",
"state": "FL",
"postal_code": "331571814",
"telephone_number": "786-586-3818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15321 S DIXIE HWY",
"address_2": "SUITE 303A",
"city": "MIAMI",
"state": "FL",
"postal_code": "331571814",
"telephone_number": "786-586-3818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "ISCHAJI",
"middle_name": "NYERERE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-14",
"last_updated": "2009-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY6163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.