Kevin Clark Robertson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10158 Issued in GA

Practice address

2001 Peachtree Rd NE Ste 705
Atlanta, GA 30309-1476

Phone

(404) 355-0743

Fax

(855) 273-3558

NPI assigned

Apr 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Orthopaedic Clinic PA 138 clinicians

Physiotherapy Associates Inc 1,432 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.9 of 100Reported as group

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krobertson74237@direct.cshs.org
• Direct secure messaging: kevin.robertson.3@8474.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 and National Provider Directory roles.

• Peachtree Orthopaedic Clinic PA

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1811912611

  GA

  Medicare reassignment Care Compare group NPD (past)
• Peachtree Orthopaedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Alpharetta, GA
  • NPI 1588802474
  NPD
• Peachtree Orthopaedic Clinic P.a.

  • Physical Therapist
  • Atlanta, GA
  • NPI 1306022264
  NPD

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1295955441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE STE 705",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-355-0743",
            "fax_number": "855-273-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE STE 705",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-355-0743",
            "fax_number": "855-273-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KEVIN",
        "middle_name": "CLARK",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17110",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA17110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dwain Keston Emburlie Robertson, M.D.
• Erica Lynn Robertson, RN
• James Van Robertson, MD
• Jan Marie Robertson, L.C.S.W.
• Jana Lisa Robertson, AU.D.
• Kim J Robertson, LMSW
• Matthew Tyler Robertson, DPT
• Michelle Robertson
• Rabun Marie Robertson, OTD, OTR/L
• Rachel Robertson, LCSW

• All providers in Atlanta, GA
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.