Individual provider Active NPI

Elena Vladimirovna Robertson, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1417229980
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-117322 Issued in AL
Practice address
7105B Bailey Creek Cir SE
Huntsville, AL 35802-2797
Phone
(256) 882-7469
Fax
(256) 425-0046
NPI assigned
Jan 31, 2012
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-117322 AL Primary

Addresses

Primary practice location

7105B Bailey Creek Cir SE
Huntsville, AL 35802-2797

Mailing address

265 Ita Ann Lane
Madison, AL 35757
Phone (256) 882-7469

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130705000449 AL Practitioner - Nurse Practitioner 2567602097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

1285 US Hwy 72 E
Athens, AL 35611-4403
Phone (256) 278-3004

8151 Whitesburg Dr SE
Huntsville, AL 35802-4557
Phone (256) 882-9711

Merit-based Incentive Payment System (MIPS)

Final score
70.43 of 100Reported as group
Quality
65.59
Improvement activities
40
Cost
64.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-117322ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC CurrentSince Jan 20, 2014 Accepting new patients
Emergency Physicians Group CurrentSince May 10, 2013 Accepting new patients
American Family Care, LLC CurrentSince Jan 20, 2014 Accepting new patients
Phoenix Emergency Care, PC Family Past Accepting new patients
Synergy Medical Partners, LLC PastSince Dec 1, 2020 Accepting new patients

Locations

366 E Meighan Blvd
Gadsden, AL 35903
Phone (256) 485-0982

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

Organizations & group practices 5

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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1417229980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 ITA ANN LANE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35757",
            "telephone_number": "256-882-7469",
            "fax_number": "256-425-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105B BAILEY CREEK CIR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022797",
            "telephone_number": "256-882-7469",
            "fax_number": "256-425-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "ELENA",
        "middle_name": "VLADIMIROVNA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-117322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.