MR. KEVIN JOSUE ROBERTSON


Address: 6420 Clayton Road, St. Louis, MO 63117
Phone: 3147688778

MR. KEVIN JOSUE ROBERTSON (NPI# 1508421629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508421629
Entity Type Individual
Full Name MR. KEVIN JOSUE ROBERTSON
Credential M.D.
Practice Address 6420 Clayton Road
St. Louis
MO 63117
Mailing Address Colonia San Jose Del Pedregal Bloque 3, Lote 3, Calle S
San Pedro Sula
CORTES 21101
HN
Practice Telephone 3147688778
Enumeration Date 2019-05-03
Last Update Date 2020-01-11
NPI Deactivation Date 12/23/2019
NPI Reactivation Date 2020-01-11
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Providers KEVIN ROBERTSON

NPI Name Taxonomy Address Enumeration
1326266636 Kevin Robertson Marriage & Family Therapist 2621 W Canyon Ave, Suite 417, San Diego, CA 92123-4732 2007-04-23
1447313747 Kevin M. Robertson Plastic Surgery 3205 Glacier Ridge Rd, Middleton, WI 53562-1765 2006-12-18
1467951954 Kevin Austin Robertson Dietitian, Registered 2002 Holcombe Blvd, Houston, TX 77030-4211 2018-02-09
1871023713 Kevin Robertson Internal Medicine 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2017-06-13
1336521947 Kevin Robertson Counselor 318 N Main St, Maryville, MO 64468-1644 2015-06-19
1497021216 Kevin James Robertson Dentist 2160 S 1st Ave, Maywood, IL 60153-3328 2012-03-26
1477757904 Kevin C Robertson Specialist/Technologist 9930 Johnnycake Ridge Rd, Suite 6b, Mentor, OH 44060-6752 2007-06-11
1295955441 Kevin Clark Robertson Physician Assistant 125 Eucalyptus Dr, El Segundo, CA 90245-3839 2007-04-30
1609948918 Kevin R Robertson Psychologist 101 Manning Dr, Chapel Hill, NC 27599-0001 2006-11-14
1780774562 Kevin Wallace Robertson Family Medicine 1375 S Lapeer Rd, Suite 106, Lake Orion, MI 48360-1421 2006-10-13

Office Location

Street Address 6420 CLAYTON ROAD
City ST. LOUIS
State MO
Zip Code 63117

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245727171 Ojaswi Singh Tomar Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 2018-04-17
1730676941 Victoria Novoselova Student in an Organized Health Care Education/Training Program 6420 Clayton Road, St. Louis, MO 63117 2018-04-13
1134658321 Alan Gonzalez Zapata Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Department of Internal Medicine, St. Louis, MO 63117 2017-06-09
1013362136 Zain Tariq Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Department of Internal Medicine, St. Mary's Health Cent, St. Louis, MO 63117 2016-04-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255956611 Efehi Kelly Ogbomo Student in an Organized Health Care Education/Training Program 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 2020-06-11
1619533890 Abdul Rauf Student in an Organized Health Care Education/Training Program 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 2019-05-14
1083278477 Mohamed Maali Gumaa Mohamed Student in an Organized Health Care Education/Training Program 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 2019-05-01
1750945556 Samrat Jun Jayanth Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 2019-04-26
1215491329 Latonya Allen Counselor 1612 S. Big Bend Blvd, St. Louis, MO 63117 2019-01-23
1265917025 Blue Stars Therapy, LLC Occupational Therapist 1101 Edward Terrace, Apt A, St. Louis, MO 63117 2018-09-27
1770060014 Ultra Care Home Services LLC Home Health 7353 Dale Ave, Saint Louis, MO 63117 2018-07-19
1235623562 Melissa Valerie Taylor Counselor Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 2018-06-20
1124517289 Jideofor Ebony Obodozie Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 2018-05-04
1770071706 Sivaram Prabhuji Muppaneni Student in an Organized Health Care Education/Training Program Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 2018-04-25
Find all providers in zip 63117

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255956611 Efehi Kelly Ogbomo Student in an Organized Health Care Education/Training Program 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 2020-06-11
1619533890 Abdul Rauf Student in an Organized Health Care Education/Training Program 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 2019-05-14
1083278477 Mohamed Maali Gumaa Mohamed Student in an Organized Health Care Education/Training Program 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 2019-05-01
1750945556 Samrat Jun Jayanth Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 2019-04-26
1174187264 Ahsan Ali Student in an Organized Health Care Education/Training Program 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 2019-04-24
1760978688 Ihab Hassanieh Student in an Organized Health Care Education/Training Program 33660 Vista Ave, St. Louis, MO 63110 2018-07-03
1124517289 Jideofor Ebony Obodozie Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 2018-05-04
1770071706 Sivaram Prabhuji Muppaneni Student in an Organized Health Care Education/Training Program Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 2018-04-25
1659868354 Francis Rafael Contreras Student in an Organized Health Care Education/Training Program 6420 Clayton Road Department of Internal Medicine, Ssm St. Mary's Hospital, St. Louis, MO 63117 2018-04-18
1437656105 Manjusha Thenozhiyil Student in an Organized Health Care Education/Training Program 6420 Clayton Road., St. Louis, MO 63117 2018-04-10
Find all providers in ST. LOUIS

Competitor

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City ST. LOUIS
Zip Code 63117

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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