Active NPI
Virginia Robertson Rollins, FNP
- Family Nurse Practitioner
- Salt Lake City, UT
National Provider Identifier
1780658740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6823884-4405
- Practice address
- 100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-4700
- Fax
- (801) 662-4707
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN077478 NP | GA | |
| Family Nurse Practitioner | 363LF0000X | 6823884-4405 | UT | Primary |
Addresses
Primary practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
5335 S 3400 W
Roy, UT 84067-9282
Phone (801) 791-6750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000576529D | Medicaid | GA |
Other names 1
- Mrs. Virginia Robertson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN077478 NP | GA | MD | Nurse Practitioner |
| 6823884-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Emergency Associates | Past | Accepting new patients | |
| Advanced Pediatric Specialists LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Savannah, GA
- NPI 1073046397
-
- Emergency Medicine Physician
- Rincon, GA
- NPI 1528098290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1780658740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5335 S 3400 W",
"city": "ROY",
"state": "UT",
"postal_code": "840679282",
"telephone_number": "801-791-6750",
"fax_number": "801-662-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-4700",
"fax_number": "801-662-4707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLINS",
"first_name": "VIRGINIA",
"middle_name": "ROBERTSON",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN077478 NP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "6823884-4405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000576529D",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VIRGINIA",
"last_name": "ROBERTSON",
"prefix": "MRS.",
"credential": "FNP",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.