Active NPI
Maria Dominique Robertson, DPT
- Physical Therapist
- Reno, NV
National Provider Identifier
1972202018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 6630 S McCarran Blvd Ste A6
Reno, NV 89509-6136 - Phone
- (775) 828-2866
- Fax
- (775) 828-2891
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NV | Primary |
Addresses
Primary practice location
6630 S McCarran Blvd Ste A6
Reno, NV 89509-6136
Mailing address
1627 Summerwind Dr
Fernley, NV 89408-7208
Phone (541) 589-3469
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5061 | NV | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lcanderson LLC | Physical Therapist | Current | Accepting new patients |
Locations
6630 S McCarran Blvd
Ste A6
Reno, NV 89509
Phone (775) 250-1870
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1972202018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 SUMMERWIND DR",
"city": "FERNLEY",
"state": "NV",
"postal_code": "894087208",
"telephone_number": "541-589-3469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6630 S MCCARRAN BLVD STE A6",
"city": "RENO",
"state": "NV",
"postal_code": "895096136",
"telephone_number": "775-828-2866",
"fax_number": "775-828-2891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "MARIA",
"middle_name": "DOMINIQUE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.