Sandra D Robertson, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4725P Issued in KY

Practice address

1311 N Dixie Hwy
Elizabethtown, KY 42701-2621

Phone

(270) 769-1304

Fax

(270) 234-8028

NPI assigned

May 18, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Communicare Inc

  • Community/Behavioral Health Agency
  • Springfield, KY
  • NPI 1083751424
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Hodgenville, KY
  • NPI 1821419789
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Elizabethtown, KY
  • NPI 1891832234
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206748800000",
    "number": "1720031172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CRANES ROOST CT",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013650",
            "telephone_number": "270-769-1304",
            "fax_number": "270-234-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N DIXIE HWY",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012621",
            "telephone_number": "270-769-1304",
            "fax_number": "270-234-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4725P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30605018",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000480985",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11571509",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamika Dianne Risner
• Taylor Ritchie
• Jessica Marie Rivera, APRN
• Shena Rivers
• Melissa D Riviello, MHA
• Anne Robinson
• Tiffany Shea Robinson, PA
• Shelley L Roby, ARNP
• Amy Rhea Rock, DC
• Rocky Mountain Holdings, LLC

• All providers in Elizabethtown, KY
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2008; 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.