Individual provider Active NPI

Robert Brooks, ITE

  • Peer Specialist
  • Riverside, CA
National Provider Identifier
1922540236
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
2085 Rustin Ave
Riverside, CA 92507-2498
Phone
(909) 491-0287
NPI assigned
Nov 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

2085 Rustin Ave
Riverside, CA 92507-2498

Mailing address

PO Box 2851
Riverside, CA 92516-2851
Phone (909) 491-0287

Other practice location 1

771 W Blaine St Ste C
Riverside, CA 92507-3940
Phone (951) 955-2233

Other practice location 2

9990 County Farm Rd Ste 5
Riverside, CA 92503-3542
Phone (909) 358-4834

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1922540236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2851",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925162851",
            "telephone_number": "909-491-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "909-491-0287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "771 W Blaine St Ste C",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925073940",
            "country_code": "US",
            "telephone_number": "951-955-2233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9990 County Farm Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033542",
            "country_code": "US",
            "telephone_number": "909-358-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "ITE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-17",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.