Codie M Robertson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1210A Issued in ID

Practice address

110 Vista Dr
Pocatello, ID 83201-4520

Phone

(208) 234-2300

NPI assigned

Aug 28, 2012

Sex

Female

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 ID

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: codie.robertson.1@16258.direct.athenahealth.com
• Direct secure messaging: crobertson363766@ahs.direct-ci.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/c2c641c8-5233-4dab-bc71-a8eadb28e83d/

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

• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Preston, ID
  • NPI 1033595541
  Medicare reassignment Care Compare group NPD
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  Medicare reassignment NPD
• Primary Care Specialists, PA

  • Primary Care Clinic/Center
  • Pocatello, ID
  • NPI 1508875881
  Medicare reassignment NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, ID
  • NPI 1295734796
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Downey, ID
  • NPI 1588666945
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • American Falls, ID
  • NPI 1629077235
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1639801350
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD
• Pocatello Health Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
  • NPI 1154089126
  NPD
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1215165485
  NPD
• Pocatello Hospital LLC

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1760610935
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1013547801
  NPD (past)

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

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1134477870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 STUART AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022262",
            "telephone_number": "208-221-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VISTA DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014520",
            "telephone_number": "208-234-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832014008",
            "country_code": "US",
            "telephone_number": "208-234-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "CODIE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1210A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W. Roberts, LCPC
• Mark West Roberts, PH.D.
• Misty A Roberts, RD,LD
• Monica Felice Roberts, FNP-C
• Verena M. Roberts, PH.D.
• Marlo Patrice Robertson, LCSW
• Janeane Robinson, CNP
• Jennifer L. Robinson, PA-C
• Calvin B. Rock, MD
• Rocky Mountain Artificial Limb & Brace, Inc

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.