Individual provider Active NPI

Katelyn Meredith Robertson, RN, APRN, NP-C

  • Family Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1396273157
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22815 Issued in TN
Practice address
2550 Parr Ave
Dyersburg, TN 38024-2033
Phone
(731) 325-5678
NPI assigned
May 24, 2017
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22815 TN Primary
Registered Nurse 163W00000X 189664 TN

Addresses

Primary practice location

2550 Parr Ave
Dyersburg, TN 38024-2033

Mailing address

2550 Parr Ave
Dyersburg, TN 38024-2033
Phone (713) 325-5678

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180609000046 TN Practitioner - Nurse Practitioner 7618222944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

2224 Madison St
Suite B
Clarksville, TN 37043-8043
Phone (931) 503-7015

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
189664TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Family CurrentSince Aug 1, 2025 Accepting new patients
Crossroads Urgent Care PLLC Family CurrentSince Aug 1, 2025 Accepting new patients
Advanced Diagnostic Imaging PC PastSince Jan 1, 2018 Accepting new patients

Locations

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1396273157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242033",
            "telephone_number": "713-325-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242033",
            "telephone_number": "731-325-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KATELYN",
        "middle_name": "MEREDITH",
        "credential": "RN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22815",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "189664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.