Laci Renae Robertson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-132480 Issued in AL

Practice address

212 Airport Road W
Fort Payne, AL 35968

Phone

(256) 979-1250

NPI assigned

Feb 17, 2021

Last updated

Mar 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

University of South Alabama College of Medicine, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Renew Family Dermatology LLCGroup PAC ID 2466789839, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.93 of 100Reported as group

Quality

70.92

Promoting interoperability

84

Improvement activities

40

Cost

98.86

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BCGEDD
• Direct secure messaging: lrob@renewfamilyderm.emadirect.md

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.

• Renew Family Dermatology LLC

  dba Renew Family Dermatology

  • Dermatology Physician
  • Fort Payne, AL
  • NPI 1275198913
  Medicare reassignment Care Compare group NPD
• Relief Spine and Pain Center LLC

  • Pain Medicine (Anesthesiology) Physician
  • Fort Payne, AL
  • NPI 1598539140
  NPD

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1407449721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 AIRPORT RD W",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683335",
            "telephone_number": "256-979-1250",
            "fax_number": "256-979-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 AIRPORT ROAD W",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "35968",
            "telephone_number": "256-979-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LACI",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-132480",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-132480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renew Family Dermatology LLC (Renew Family Dermatology)
• Tristan Brooke Rice, LICSW
• John Harley Roberts
• Laura Leonard Roberts, M.S., ALC, NCC
• Lindsey Roberts, PHARM. D.
• Robyn Reesman, O.D.,Inc.
• Frine T Roca, MD
• Bryan Rosa, MD
• Carlie Anastasia Rutledge, CRNP
• Asmitha Kathleen Sathiyakumar, MD

• Nurse Practitioner in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.