Organization Active NPI

Gregory Robertson, M.D., P.C.

  • Surgery Physician
  • Tucson, AZ
National Provider Identifier
1902239551
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17506 Issued in AZ
Legal business name
GREGORY ROBERTSON, M.D., P.C.
Practice address
5240 E Knight Dr
Suite 118
Tucson, AZ 85712-2122
Phone
(520) 319-1455
Fax
(520) 316-1454
NPI assigned
Aug 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Dr. Gregory Robertson, M.C.
Title
Owner/Physician
Phone
(520) 319-1455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 17506 AZ Primary

Addresses

Primary practice location

5240 E Knight Dr
Suite 118
Tucson, AZ 85712-2122

Mailing address

5240 E Knight Dr
Suite 118
Tucson, AZ 85712-2122
Phone (520) 319-1455

Other identifiers 1

IdentifierTypeStateIssuer
296170-004MedicaidAZ

National Provider Directory

National Provider Directory

Locations

5240 E Knight Dr
Ste 118
Tucson, AZ 85712
Phone (520) 319-1455

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1902239551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR",
            "address_2": "SUITE 118",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "520-319-1455",
            "fax_number": "520-316-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR",
            "address_2": "SUITE 118",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "520-319-1455",
            "fax_number": "520-316-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY ROBERTSON, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "520-319-1455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.C."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AZ",
            "license": "17506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296170-004",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.