ROBERT J NETHERLAND NP NPI 1063767473

NPI Information

NPI: 1063767473
Provider Name: ROBERT J NETHERLAND, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2000 BROOKSIDE DR
3RD FLOOR
KINGSPORT, TN
ZIP 37660
Phone: (423) 857-5905
Get Directions

Robert J Netherland, NP is a family nurse practitioner in Kingsport, TN. Robert J Netherland, NP NPI is 1063767473. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2000 BROOKSIDE DR
3RD FLOOR
KINGSPORT, TN
ZIP 37660-627
Phone: (423) 857-5905
Fax: (423) 857-5904

The NPI 1063767473 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/23/2012 and was last updated on 2/21/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	16816	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1063767473	MEDICAID	VIRGINIA
2	7100220310	MEDICAID	KENTUCKY
3	P01312579	OTHER	TENNESSEE	RAILROAD MEDICARE
4	1530134	MEDICAID	TENNESSEE
5	103I507723	MEDICARE PIN	TENNESSEE
6	1063767473	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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