Active NPI
Robert Walter Eckert, MD
- Family Medicine Physician
- Medford, OR
National Provider Identifier
1942207592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 24005
- Practice address
- 19 Myrtle St
Medford, OR 97504-7337 - Phone
- (541) 773-3863
- Fax
- (541) 618-4413
- NPI assigned
- Jun 28, 2005
- Last updated
- Jan 14, 2010
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 24005 | OR | Primary |
Addresses
Primary practice location
19 Myrtle St
Medford, OR 97504-7337
Mailing address
19 Myrtle St
Medford, OR 97504-7337
Phone (541) 773-3863
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227698 | Medicaid | OR |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24005 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1942207592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 MYRTLE ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047337",
"telephone_number": "541-773-3863",
"fax_number": "541-618-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 MYRTLE ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047337",
"telephone_number": "541-773-3863",
"fax_number": "541-618-4413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKERT",
"first_name": "ROBERT",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "24005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227698",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.