Nettie Renea Roberts

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4009445 Issued in KY

Practice address

615 7TH Ave
Bowling Green, KY 42101-6921

Phone

(615) 519-4858

NPI assigned

Oct 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15294/brand/1/csg/1/fhir/r4

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.

• Swan Surgical, PLLC

  • Vascular Surgery Physician
  • Hendersonville, TN
  • NPI 1811121015
  NPD (past)

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1487436176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 GIRKIN RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421018611",
            "telephone_number": "615-869-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 7TH AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421016921",
            "telephone_number": "615-519-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NETTIE",
        "middle_name": "RENEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4009445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Byrd MD, LLC
• Robert Fane Agency, LLCP
• Brittani Roberts, LPCA
• Holly Roberts, RBT
• Kyleigh Grace Roberts
• Rachel Elizabeth Roberts, APRN
• Anna Robertson, RBT
• Joel Aaron Robertson
• Stephen Wayne Robertson, D.M.D.,
• Angela Robinson

• Family Nurse Practitioner in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.