1235124470 NPI number — DR. LINDA J ROBINSON DO

Table of content: DR. LINDA J ROBINSON DO (NPI 1235124470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235124470 NPI number — DR. LINDA J ROBINSON DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
LINDA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

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:
1235124470
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7261 MERCY RD
Provider Second Line Business Mailing Address:
ATTN CLINIC CREDENTIALING
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68124-2311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-322-6338
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENOX
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50851-1242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-322-6338
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2005

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: 207Q00000X , with the licence number:  01913 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: IA0102 . This is a "HERITAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1196015 . This is a "COVOP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28113 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 14955 . This is a "HCP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 420870851 . This is a "COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0030296 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001007 . This is a "SECURE CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0100034 . This is a "COVPC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 119601S . This is a "COVENTRY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com