MR. NATHAN KELLY ROBERSON (NP-C) – Nurse Practitioner, NPI 1023532280

MR. NATHAN KELLY ROBERSON (NP-C) is a healthcare provider. based in Valdosta, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN214086 (GA). The NPI Number for MR. NATHAN KELLY ROBERSON (NP-C) is 1023532280

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
MR. NATHAN KELLY ROBERSON (NP-C)
NPI
1023532280
Phone
(229) 333-9736
Address
4340 KINGS WAY
Enumeration Date
31 July 2017
Last Update Date
30 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2292428480
Graduation Year
2017 (9 years ago)
PAC ID
6507122306
Group Practice PAC ID
4082036843
Professional Enrollment ID
I20171110002426
Address ID
GA316051029VA3207XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MR. NATHAN KELLY ROBERSON (NP-C)

  • 4340 KINGS WAY

    VALDOSTA, GA 316026921

    Phone: (229) 333-9736

    Type: Location

  • 202 S Madison St

    Thomasville, GA 317925479

    Phone: (229) 333-9736

    Type: Location

  • 207 31st Ave SE

    Moultrie, GA 317686703

    Phone: (229) 333-9736

    Type: Location

  • 1430 US Highway 82 W

    Tifton, GA 317938011

    Phone: (229) 333-0225

    Type: Location

  • 2804, North Oak Street, Five Points, Valdosta, Lowndes County, Georgia, 31602, United States

    VALDOSTA, GA 316025913

    Phone: (229) 241-8925

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $48.

Total Amount is formed as General ($48) + Research ($0) + Ownership ($0) = $48.

Last reported payment date: 2024-06-12 • Largest payer in this snapshot: Lilly USA, LLC ($20).

Total Amount

$48

General + Research + Ownership

Payments

3

Total payment records

General Amount

$48

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-12

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2017-11-10

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
I20171110002426INurse PractitionerGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes4847$0
87804Detection test by immunoassay with direct visual observation for influenza virus2814$0
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus1414$0
View full utilization report →

Insurance plans in this area (ZIP 31602)

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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: 4082036843View full group profile
NameSpecialtyState
Family PracticeGA
Critical Care (Intensivists), Internal Medicine, Pulmonary DiseaseNY
Nurse PractitionerGA
Orthopedic SurgeryGA
N E U R O L O G YGA
General Surgery, Vascular SurgeryGA
Pulmonary Disease, Sleep MedicineWI
N E U R O S U R G E R YCA
Family PracticeGA
Thoracic Surgery, General SurgeryGA

Reviews

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Frequently asked questions

What is the standard ID for MR. NATHAN KELLY ROBERSON (NP-C) in the U.S.?
In the U.S., MR. NATHAN KELLY ROBERSON (NP-C) is identified by NPI 1023532280.
Does the public listing show MR. NATHAN KELLY ROBERSON (NP-C) as active?
MR. NATHAN KELLY ROBERSON (NP-C)'s NPI record reflects an active status in NPPES.
Which specialty label fits MR. NATHAN KELLY ROBERSON (NP-C)?
NPPES ties MR. NATHAN KELLY ROBERSON (NP-C) to Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. NATHAN KELLY ROBERSON (NP-C)?
MR. NATHAN KELLY ROBERSON (NP-C) shows a connection to Valdosta, Georgia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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