Provider Demographics
NPI:1780606871
Name:NORTHINGTON, ROBIN MORGAN (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MORGAN
Last Name:NORTHINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 BENNETT SPRINGS DR APT 202
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7282
Mailing Address - Country:US
Mailing Address - Phone:251-802-6581
Mailing Address - Fax:
Practice Address - Street 1:200 N KEENE ST STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8145
Practice Address - Country:US
Practice Address - Phone:573-874-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917620Medicaid
ALDB9027OtherRAILROAD MEDICARE GROUP
AL1003819608OtherGROUP NPI
AL515-28304OtherBCBS
ALK531OtherMEDICARE GROUP