Individual provider Active NPI

Detris Lashall Roberson, APRN

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1427931302
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP289668 Issued in GA
Practice address
SC House Calls, Inc
111 Doctors Cir.
Columbia, SC 29203
Phone
(800) 491-0909
NPI assigned
Jul 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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 APRN-NP289668 GA Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X RN289668 GA

Addresses

Primary practice location

SC House Calls, Inc
111 Doctors Cir.
Columbia, SC 29203

Mailing address

SC House Calls, Inc
111 Doctors Cir.
Columbia, SC 29203
Phone (800) 491-0909

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250929003978 GA Practitioner - Nurse Practitioner 3870099856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 Doctor Cir
Columbia, SC 29203-6502

315 W Ponce de Leon Ave
Suite 1000
Decatur, GA 30030-2433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN289668GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Georgia Healthcare Center, Inc. CurrentSince Jul 1, 2025 Accepting new patients
East Georgia Healthcare Center, Inc. CurrentSince Jul 1, 2025 Accepting new patients
East Georgia Healthcare Center, Inc. Multi-Specialty Current Accepting new patients

Locations

1075 E Winthrope Ave
Millen, GA 30442
Phone (478) 237-2638

215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-2638

Organizations & group practices 3

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": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1427931302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS, INC",
            "address_2": "111 DOCTORS CIR.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS, INC",
            "address_2": "111 DOCTORS CIR.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "DETRIS",
        "middle_name": "LASHALL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP289668",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN289668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.