Elizabeth Roberson, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

32101 Issued in TN

Practice address

1954 Saint John Ave Ste B
Dyersburg, TN 38024-2120

Phone

(731) 285-6110

NPI assigned

Sep 8, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dyersburg Family Walk-in ClinicGroup PAC ID 5991793879, 24 clinicians

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dyersburg Family Walk-in Clinic LLC

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1174712780
  Medicare reassignment Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  TN

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Neighborhood Pharmacy LLC

  • Pharmacy
  • Dyersburg, TN
  • NPI 1336691856
  NPD (past)

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1205557261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 SAINT JOHN AVE STE B",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242120",
            "telephone_number": "731-285-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 SAINT JOHN AVE STE B",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242120",
            "telephone_number": "731-285-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "32101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "elizabeth.roberson@fastpacehealth.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "elizabeth.roberson@fastpacehealth.com",
            "address_1": "1954 Saint John Ave Ste B",
            "city": "Dyersburg",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380242120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Revitalize Counseling & Consultation Services
• Anne Barret Richards, MSN, APRN, FNP-C
• Jane Alison Riles, DNP-C
• Riverside Surgery Center, LLC
• Courtney White Roberson, NP
• David Allen Roberts, PA-C
• Michelle Renee Roberts, FNP-BC
• Erica Nicole Robertson
• Katelyn Meredith Robertson, RN, APRN, NP-C
• Brian Keith Robinson, O.D.

• Primary Care Nurse Practitioner in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.