DR. JAMES WALLACE ROBERTSON (NPI# 1457357832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457357832 |
| Entity Type | Individual |
| Full Name | DR. JAMES WALLACE ROBERTSON |
| Credential | MD |
| Practice Address |
5024 N Royal Dr Traverse City MI 49684-9230 |
| Practice Telephone | 2319350555 |
| Practice Fax Number | 2319350562 |
| Mailing Telephone | 2319350555 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2019-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301065685 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1065685 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 829 N Center Ave Ste 130, Gaylord, MI 497351684 | 9897317930 | |
| 14719 W Upright St, Charlevoix, MI 497201949 | 2315473840 | |
| 1250 E Michigan Ave, Grayling, MI 497387074 | 9893480550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659776748 | James Robertson | Pharmacist | 2727 Church Rd, Columbus, MI 48063-4221 | 2014-10-31 |
| 1962768481 | James Ryan Robertson | Nurse Practitioner | 1 E Market St Ste C1, Martinsville, VA 24112-3747 | 2012-04-10 |
| 1487939922 | James Douglas Robertson | Pharmacist | 202 Harper Ave Nw Ste A, Lenoir, NC 28645-5196 | 2011-10-17 |
| 1457516437 | James Thomas Robertson | Neurological Surgery | 189 Crestview Dr, Brevard, NC 28712-8890 | 2008-07-19 |
| 1750594412 | James Michael Robertson | Dentist | 103 Parkgate Drive Extended, Tupelo, MS 38801-3038 | 2007-05-08 |
| 1275657371 | James Bruce Robertson | Urology | 2002 N 22nd Ave Ste 1, Bozeman, MT 59718-3153 | 2007-03-16 |
| 1548300536 | James Michael Robertson | Counselor | 1672n 600w, Greenfield, IN 46140-9626 | 2007-02-07 |
| 1679632822 | James B. Robertson | Audiologist | 117 Bluebell Dr, Mechanicsburg, PA 17050-3726 | 2006-12-06 |
| 1891898359 | James Robbie Robertson | Chiropractor | 2918 Saint Marys Ave, Hannibal, MO 63401-3715 | 2006-09-07 |
| 1003820986 | James Marvin Robertson | Dentist | 369 E Chicago St, Coldwater, MI 49036-2002 | 2006-07-28 |
| Street Address |
5024 N ROYAL DR |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-9230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346759297 | Rebecca Elaine Baker | Registered Nurse | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2017-09-22 |
| 1760782361 | Spectrum Health Primary Care Partners | Pediatrics | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2010-10-28 |
| 1780903187 | Joan Elizabeth Hazelton | Social Worker | 5024 N Royal Dr, Ste B, Traverse City, MI 49684-9230 | 2010-05-25 |
| 1710045661 | Alicia Classens | Nurse Practitioner | 5024 N Royal Dr, Kids Creek Children's Clinic, Traverse City, MI 49684-9230 | 2006-12-04 |
| 1043311731 | Cynthia Smith | Pediatrics | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2006-09-26 |
| 1386745073 | Michael Eldredge | Pediatrics | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2006-09-26 |
| 1649291832 | Kids Creek Childrens Clinic | Pediatrics | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376854653 | Matthew Glenn Arnold | Pediatrics | 1105 6th St Ste 342, Traverse City, MI 49684-2345 | 2010-07-01 |
| 1346485505 | Ann Timmermann Smith | Pediatrics | 7835 Truesdale Lane, Traverse City, MI 49686-1667 | 2008-12-02 |
| 1689885824 | Sarah Christine Mulder | Pediatrics | 4020 W. Royal Drive, Traverse City, MI 49684-7548 | 2007-05-26 |
| 1851379770 | Kimberly A Hegewald | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2006-01-03 |
| 1700291515 | Alyssa M Vermeulen | Pediatrics | 1105 Sixth St, Traverse City, MI 49684-2345 | 2014-07-01 |
| 1568704922 | Megan Leah Stilwill | Pediatrics | 4020 W Royal Dr, Traverse City, MI 49684-8965 | 2013-03-25 |
| 1992081640 | Regents of The University of Michigan | Pediatrics | 1200 Sixth St, Suite 100, Traverse City, MI 49684-2369 | 2011-10-26 |
| 1821380031 | Traverse Area Pediatric and Adolescent Clinic Plc | Pediatrics | 4020 W Royal Dr, Traverse City, MI 49684-8965 | 2011-05-05 |
| 1548575764 | Tuan Bui | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2010-08-12 |
| 1730342247 | Sunil David Maddirala | Pediatrics | 4075 Copper Ridge Dr, Traverse City, MI 49684-7059 | 2008-07-03 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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| 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.