KASSIE OLIVIA ROBERTSON (APN) – Family Nurse Practitioner, NPI 1811635634

KASSIE OLIVIA ROBERTSON (APN) is a healthcare provider. based in Conway, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 220074 (AR). The NPI Number for KASSIE OLIVIA ROBERTSON (APN) is 1811635634

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KASSIE OLIVIA ROBERTSON (APN)
NPI
1811635634
Phone
(501) 327-6547
Address
2180 ADA AVE STE 300
Enumeration Date
23 May 2022
Last Update Date
24 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5013276547101
Graduation Year
2022 (4 years ago)
PAC ID
1254719826
Group Practice PAC ID
9931184280
Professional Enrollment ID
I20220610000178
Address ID
AR720344300CO2180XAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

Provider Addresses for KASSIE OLIVIA ROBERTSON (APN)

  • 2180 ADA AVE STE 300

    CONWAY, AR 720344300

    Phone: (501) 327-6547

    Fax: (501) 327-9715

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 40 Open Payments records for all available years, with a total value of $694.

Total Amount is formed as General ($694) + Research ($0) + Ownership ($0) = $694.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($102).

Total Amount

$694

General + Research + Ownership

Payments

40

Total payment records

General Amount

$694

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-06-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220610000178INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72034)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931184280View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YAR
O B S T E T R I C S/ G Y N E C O L O G YAR
Nurse PractitionerAR
Nurse PractitionerAR
O B S T E T R I C S/ G Y N E C O L O G YAR
O B S T E T R I C S/ G Y N E C O L O G YAR
-AR
O B S T E T R I C S/ G Y N E C O L O G YAR
Nurse PractitionerAR
-AR

Reviews

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Frequently asked questions

How do I look up KASSIE OLIVIA ROBERTSON (APN) by NPI?
Use NPI 1811635634 when you need to reference KASSIE OLIVIA ROBERTSON (APN) in forms, claims, or directories.
Is KASSIE OLIVIA ROBERTSON (APN) active in the national directory?
KASSIE OLIVIA ROBERTSON (APN)'s public NPI profile is in an active state.
What kind of provider is KASSIE OLIVIA ROBERTSON (APN)?
The page reflects Family Nurse Practitioner for KASSIE OLIVIA ROBERTSON (APN). Clinical services aligned with this taxonomy classification.
Does KASSIE OLIVIA ROBERTSON (APN) practice in Arkansas?
You will see Conway, Arkansas on file for KASSIE OLIVIA ROBERTSON (APN) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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