Active NPI
Robert Thomas Pitman
- Mental Health Counselor
- Davenport, IA
National Provider Identifier
1992487417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5403 Victoria Ave
Davenport, IA 52807-3925 - Phone
- (563) 296-0877
- NPI assigned
- Aug 3, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
5403 Victoria Ave
Davenport, IA 52807-3925
Mailing address
113 1St St
Coal Valley, IL 61240-9307
Phone (623) 999-3536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260314000430 | IA | Practitioner - Mental Health Counselor | 5395228688 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1441 W Central Park Ave
Davenport, IA 52804-1707
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Family Solutions, LLC | Current | Accepting new patients | |
| Vera French Community Mental Health | Past | Accepting new patients |
Locations
5403 Victoria Ave
Davenport, IA 52807
Phone (563) 296-0877
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Davenport, IA
- NPI 1245291129
IA
-
- Community/Behavioral Health Agency
- Cedar Rapids, IA
- NPI 1407295280
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1992487417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 1ST ST",
"city": "COAL VALLEY",
"state": "IL",
"postal_code": "612409307",
"telephone_number": "623-999-3536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5403 VICTORIA AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528073925",
"telephone_number": "563-296-0877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITMAN",
"first_name": "ROBERT",
"middle_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-03",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.