Individual provider Active NPI

Cynthia R Robertson, C.N.P.

  • Family Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1912974395
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R-115456-0 Issued in MN
Practice address
1900 Centracare Circle
Centracare Clinic - Health Plaza Specialties
St Cloud, MN 56303-5000
Phone
(320) 229-4907
NPI assigned
Mar 3, 2006
Last updated
Jul 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X MNR1154560 MN
Family Nurse Practitioner 363LF0000X R-115456-0 MN Primary

Addresses

Primary practice location

1900 Centracare Circle
Centracare Clinic - Health Plaza Specialties
St Cloud, MN 56303-5000

Mailing address

1900 Centracare Circle
Centracare Clinic - Health Plaza Specialties
St Cloud, MN 56303-5000
Phone (320) 229-4907

Other identifiers 1

IdentifierTypeStateIssuer
251220300MedicaidMN

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
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MNR1154560MNMDFamily Nurse Practitioner
R-115456-0MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health Systems Current Accepting new patients
St Cloud Pathologists PA Current Accepting new patients
Regional Diagnostic Radiology Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Health-Paynesville LLC Past Accepting new patients
Paynesville Area Hospital District Past Accepting new patients

Locations

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

1555 Northway Dr
Ste 200
Saint Cloud, MN 56303
Phone (320) 240-3157

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

Interoperability endpoints

  • Direct secure messaging: crobertson939@direct.centracare.com

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1912974395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIRCLE",
            "address_2": "CENTRACARE CLINIC - HEALTH PLAZA SPECIALTIES",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIRCLE",
            "address_2": "CENTRACARE CLINIC - HEALTH PLAZA SPECIALTIES",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "CYNTHIA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "MNR1154560",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-115456-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251220300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.