Nathan Kelly Roberson, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN214086 Issued in GA

Practice address

4340 Kings Way
Valdosta, GA 31602-6921

Phone

(229) 333-9736

NPI assigned

Jul 31, 2017

Last updated

Jul 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122
• SGMC Berrien Campus Hospital, Nashville, GA, CCN 110234
• SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: nathan.roberson.1@7117.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SGMC Physician Network Inc

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1417597170
  Medicare reassignment Care Compare group NPD
• Care Medical Center LLC

  • Exclusive Provider Organization
  • Valdosta, GA
  • NPI 1063521250
  Medicare reassignment NPD
• Valdosta Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Valdosta, GA
  • NPI 1114962255
  Medicare reassignment NPD
• Care Medical Center LLC

  • Chiropractor
  • Waycross, GA
  • NPI 1376236232
  NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation
• South Georgia Medical Center Inc

  dba SGMC Health Lanier

  • Critical Access Hospital
  • Lakeland, GA
  • NPI 1215703632
  Care Compare affiliation
• South Georgia Medical Center Inc

  dba SGMC Berrien Campus

  • General Acute Care Hospital
  • Nashville, GA
  • NPI 1689440091
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1023532280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 N OAK ST STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025913",
            "telephone_number": "229-241-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026921",
            "telephone_number": "229-333-9736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 31st Ave SE",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686703",
            "country_code": "US",
            "telephone_number": "229-333-9736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317925479",
            "country_code": "US",
            "telephone_number": "229-333-9736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1430 US Highway 82 W",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317938011",
            "country_code": "US",
            "telephone_number": "229-333-0225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "NATHAN",
        "middle_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN214086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John David Roan, DDS
• Robert Robe, CRNA
• Cristina Roberson Perez
• Alisha Lashay Roberts
• Andrael Chantal Roberts
• Annadale Marie Roberts
• Betty V Roberts, LPC
• Cedric Roberts

• Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.