Individual provider Active NPI

Victoria A Roebuck, WHNP, MSN

  • Women's Health Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1881748952
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN074697 Issued in GA
Practice address
4225 University Ave
Columbus, GA 31907-5645
Phone
(706) 507-8620
Fax
(706) 568-2323
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN074697 GA Primary

Addresses

Primary practice location

4225 University Ave
Columbus, GA 31907-5645

Mailing address

4225 University Ave
Columbus, GA 31907-5679
Phone (706) 507-8620

Other identifiers 3

IdentifierTypeStateIssuer
00850099AMedicaidGA
00850099AOtherGAWELLCARE
000850099AOtherGAPEACH STATE

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2017 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1881748952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 UNIVERSITY AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319075679",
            "telephone_number": "706-507-8620",
            "fax_number": "706-568-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 UNIVERSITY AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319075645",
            "telephone_number": "706-507-8620",
            "fax_number": "706-568-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "WHNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN074697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00850099A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "00850099A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE",
            "identifier": "000850099A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.