Individual provider Active NPI

Robert Ernest Watkins Jr., DC

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1942298831
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007331 Issued in FL
Practice address
6430 Plantation Park CT Ste 100
Fort Myers, FL 33966-4815
Phone
(239) 590-9555
Fax
(866) 254-8158
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007331 FL Primary

Addresses

Primary practice location

6430 Plantation Park CT Ste 100
Fort Myers, FL 33966-4815

Mailing address

6430 Plantation Park CT Ste 100
Fort Myers, FL 33966-4815
Phone (239) 590-9555

Other practice location 1

6430 Plantation Park Ct Ste 100
Fort Myers, FL 33966-4815
Phone (239) 590-9555

Other identifiers 5

IdentifierTypeStateIssuer
55775OtherBCBS #
3811751-00MedicaidFL
350044658OtherRR MEDICARE
3811751-01MedicaidFL
350044658OtherUHC RR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000599 FL Practitioner - Chiropractic 6002889524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

367 W Hickpoochee Ave
Labelle, FL 33935-4761
Phone (239) 590-9555

6430 Plantation Park
Suite 100
Fort Myers, FL 33966-4720

6430 Plantation Park CT
Suite 100
Fort Myers, FL 33966-4720
Phone (239) 590-9555

7051 Cypress Terrace
Suite 106
Fort Myers, FL 33907-8801
Phone (239) 590-9555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0007331FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E Watkins Jr DC Inc Chiropractor CurrentSince Jan 11, 2011 Accepting new patients
Robert E Watkins Jr Chiropractor PastSince Jan 1, 1990 Accepting new patients

Locations

6430 Plantation Park Ct
Ste 100
Fort Myers, FL 33966
Phone (239) 590-9555

7051 Cypress Ter
Ste 106
Fort Myers, FL 33907
Phone (239) 270-3973

367 W Hickpochee Ave
Labelle, FL 33935
Phone (239) 590-9555

870 W Hickpochee Ave
Ste 700
Labelle, FL 33935
Phone (863) 674-9001

870 W Hickpochee Ave
Labelle, FL 33935

Organizations & group practices 2

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1942298831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 PLANTATION PARK CT STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664815",
            "telephone_number": "239-590-9555",
            "fax_number": "866-254-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 PLANTATION PARK CT STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664815",
            "telephone_number": "239-590-9555",
            "fax_number": "866-254-8158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6430 Plantation Park Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339664815",
            "country_code": "US",
            "telephone_number": "239-590-9555",
            "fax_number": "866-254-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "ROBERT",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "55775",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3811751-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350044658",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3811751-01",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC RR MEDICARE",
            "identifier": "350044658",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.