Individual provider Active NPI

Nadine Robertson, MD

  • Psychiatry Physician
  • Panama City, FL
National Provider Identifier
1871112854
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME168780 Issued in FL
Practice address
1940 Harrison Ave
Panama City, FL 32405-4542
Phone
(850) 763-0017
NPI assigned
Apr 10, 2020
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X ME168780 FL Primary

Addresses

Primary practice location

1940 Harrison Ave
Panama City, FL 32405-4542

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (205) 996-6170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812004145 FL Practitioner - Psychiatry 9133542152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Virginia Commonwealth University, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Assertive Comprehensive Care IncGroup PAC ID 7214381052, 3 clinicians

Practice addresses (Care Compare)

12550 Biscayne Blvd
Suite 507
North Miami, FL 33181-2544

650 NW 180TH Terrace
Suite 101
Pembroke Pines, FL 33181-2825
Phone (305) 204-1209

7900 Oak LN
Suite 400
Miami Lakes, FL 33016-6001
Phone (305) 204-1209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME168780FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Psychiatry Group LLC Psychiatry CurrentSince Aug 2, 2025 Accepting new patients
Assertive Comprehensive Care Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

11420 N Kendall Dr
Ste 207
Miami, FL 33176
Phone (786) 715-9183

7900 Oak Ln
Ste 400
Miami Lakes, FL 33016
Phone (203) 350-2116

12550 Biscayne Blvd
Ste 507
North Miami, FL 33181
Phone (305) 204-1209

650 NW 180th Ter
Ste 101
Pembroke Pines, FL 33029
Phone (305) 204-1209

Networks

  • Freedom Health HMO Network

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, 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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1871112854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-996-6170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "NADINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME168780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.