Individual provider Active NPI

Sherri A Robertson, DNP, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1790894335
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R739582 Issued in MS
Practice address
4209 Lincoln Rd
Hattiesburg, MS 39402-3065
Phone
(601) 705-2896
Fax
(601) 264-0732
NPI assigned
Aug 29, 2006
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R739582 MS Primary

Addresses

Primary practice location

4209 Lincoln Rd
Hattiesburg, MS 39402-3065

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 705-2896

Other identifiers 2

IdentifierTypeStateIssuer
00118300MedicaidMS
640507572YWOtherMSAMERICAN ADMIN GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srobertson50512@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital Current Accepting new patients
Inland Family Practice Center LLC CurrentSince Jan 1, 2014 Accepting new patients
Covington County Hospital CurrentSince Apr 1, 2022 Accepting new patients
Covington County Hospital CurrentSince Apr 1, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Locations

3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292

3700 Hardy St
Ste 10
Hattiesburg, MS 39402
Phone (601) 544-7012

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/covingc-3983785e
  • Direct secure messaging: srobertson50512@directpatientrecord.com

Organizations & group practices 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1790894335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-705-2896",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 LINCOLN RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023065",
            "telephone_number": "601-705-2896",
            "fax_number": "601-264-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SHERRI",
        "middle_name": "A",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R739582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118300",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572YW",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srobertson50512@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4209 Lincoln Rd",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394023065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.