MRS. LISA ROSEBERRY (NP) – Family Nurse Practitioner, NPI 1871969469

MRS. LISA ROSEBERRY (NP) is a healthcare provider. based in Forest park, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN075080 (GA). The NPI Number for MRS. LISA ROSEBERRY (NP) is 1871969469

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. LISA ROSEBERRY (NP)
NPI
1871969469
Phone
(404) 366-3636
Address
4905 COURTNEY DR
Enumeration Date
18 August 2015
Last Update Date
5 April 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6787868677
Graduation Year
2015 (11 years ago)
PAC ID
5799031860
Group Practice PAC ID
3274559323
Professional Enrollment ID
I20180702003356
Address ID
GA300393929SN3991XWXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MRS. LISA ROSEBERRY (NP)

  • 4905 COURTNEY DR

    FOREST PARK, GA 302971427

    Phone: (404) 366-3636

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2018-07-02

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
I20180702003356INurse 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
J1100Injection, dexamethasone sodium phosphate, 1 mg12015$0
99213Established patient office or other outpatient visit, 20-29 minutes8668$0
87804Detection test by immunoassay with direct visual observation for influenza virus7033$0
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus6557$0
99203New patient office or other outpatient visit, 30-44 minutes4040$0
View full utilization report →

Insurance plans in this area (ZIP 30297)

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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: 3274559323View full group profile
NameSpecialtyState
Physician AssistantGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Family Practice, Physical Medicine And RehabilitationGA
Nurse PractitionerGA
-GA
-GA

Reviews

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Frequently asked questions

What is the registry number for MRS. LISA ROSEBERRY (NP)?
The registry entry for MRS. LISA ROSEBERRY (NP) shows NPI 1871969469.
Does the public listing show MRS. LISA ROSEBERRY (NP) as active?
MRS. LISA ROSEBERRY (NP)'s NPI record reflects an active status in NPPES.
How should patients interpret MRS. LISA ROSEBERRY (NP)'s specialty?
The extract shows Family Nurse Practitioner for MRS. LISA ROSEBERRY (NP). Clinical services aligned with this taxonomy classification.
Which community is linked to MRS. LISA ROSEBERRY (NP)?
MRS. LISA ROSEBERRY (NP) shows a connection to Forest Park, Georgia in registry-derived data.
Who maintains MRS. LISA ROSEBERRY (NP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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