1992772925 NPI number — NICHOLAS J ROBERT M.D.

Table of content: NICHOLAS J ROBERT M.D. (NPI 1992772925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992772925 NPI number — NICHOLAS J ROBERT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBERT
Provider First Name:
NICHOLAS
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992772925
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8503 ARLINGTON BLVD
Provider Second Line Business Mailing Address:
STE 400
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-4629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-280-5390
Provider Business Mailing Address Fax Number:
703-280-9596

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8503 ARLINGTON BLVD
Provider Second Line Business Practice Location Address:
STE 400
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-4629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-280-5390
Provider Business Practice Location Address Fax Number:
703-280-9596
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  0101046864 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0870-005 . This is a "BCBS NCA CARE FIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1992772925 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5983432004 . This is a "CIGNA POS/PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 112924 . This is a "KAISER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 500617-500599 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 145010 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3000002 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 316256-516255 . This is a "MAMSI/OP CHOICE/ALLIANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541795091 . This is a "PHCS PPO/POS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 220659 . This is a "TRIGON/ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5983432004 . This is a "CIGNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 500617-4141420 . This is a "AETNA PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 504741 . This is a "NCPPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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