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Detra Chambers Robinson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

14215 Ballantyne Corporate Pl Ste 130, Charlotte, NC 28277-3671

(704) 384-1950

PECOS Enrollment

This provider is enrolled in PECOS as DETRA ROBINSON.

Based on the most recent information from CMS, provider Detra Chambers Robinson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1164709705
Provider Type
Individual
Full Name
Robinson, Detra Chambers
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/10/2011
Last Updated
10/25/2020

Contact Information

Practice Location

14215 Ballantyne Corporate Pl Ste 130, Charlotte, NC 28277-3671

(704) 384-1950

(704) 384-1955

Mailing Location

PO Box 60447, Charlotte, NC 28260-0447

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-03089 North Carolina

Detra Chambers Robinson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Short, Jennifer Marie

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White, Catherine

Fair, Rachel Denise

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Sullins, Alyssa Leigh