Individual provider Active NPI

Jessica Robertson

  • Acute Care Nurse Practitioner
  • Gadsden, AL
National Provider Identifier
1770459802
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-130919 Issued in AL
Practice address
851 Goodyear Ave
Gadsden, AL 35903-1133
Phone
(256) 494-4000
NPI assigned
Oct 15, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-130919 AL Primary

Addresses

Primary practice location

851 Goodyear Ave
Gadsden, AL 35903-1133

Mailing address

401 Cove Creek Rd
Gadsden, AL 35903-1405

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
I20251125003475 AL Practitioner - Nurse Practitioner 8729570874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 S 3Rd St
Gadsden, AL 35901-5305
Phone (256) 546-1445

Hospital & facility affiliations

  • Riverview Regional Medical Center Hospital, Gadsden, AL, CCN 010046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-130919ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services-Gadsden Physician Management LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

705 S 3rd St
Gadsden, AL 35901
Phone (256) 546-1445

1642A Pelham Rd S
Jacksonville, AL 36265
Phone (256) 543-1222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10998/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1770459802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COVE CREEK RD",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 GOODYEAR AVE",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031133",
            "telephone_number": "256-494-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-10-15",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-130919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.