DR. GARY ALAN ROBERSON (M. D.) – Psychiatry Physician, NPI 1629133400

DR. GARY ALAN ROBERSON (M. D.) is a healthcare provider. based in Jackson, Mississippi. specializing in Psychiatry Physician. They hold the professional credentials M. D.. They hold a License No. 15474 (MS). The NPI Number for DR. GARY ALAN ROBERSON (M. D.) is 1629133400

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. GARY ALAN ROBERSON (M. D.)
NPI
1629133400
Phone
(601) 906-4479
Address
1855 LAKELAND DR
Enumeration Date
22 December 2006
Last Update Date
6 September 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
6019519863
Graduation Year
1995 (31 years ago)
PAC ID
1456252618
Group Practice PAC ID
0749572915
Professional Enrollment ID
I20090115000699
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for DR. GARY ALAN ROBERSON (M. D.)

  • 1855, Lakeland Drive, Flowood, Hinds County, Mississippi, 39216, United States

    SUITE P-231

    JACKSON, MS 392164913

    Phone: (601) 906-4479

    Fax: (601) 366-3256

    Type: Mailing

  • 3550 HIGHWAY 468 WEST

    WHITFIELD, MS 391930157

    Phone: (601) 351-8000

    Fax: (601) 351-8301

    Type: Location

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: 2004-01-20

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
I20040120000367IPsychiatryMSTBD

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 39216)

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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: 0749572915View full group profile

Reviews

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Frequently asked questions

How is DR. GARY ALAN ROBERSON (M. D.) identified in CMS data?
CMS-hosted NPPES data lists DR. GARY ALAN ROBERSON (M. D.) with NPI 1629133400.
Is DR. GARY ALAN ROBERSON (M. D.) still practicing?
DR. GARY ALAN ROBERSON (M. D.) is currently listed as active in the public NPI registry.
What is DR. GARY ALAN ROBERSON (M. D.)'s specialty?
The listing groups DR. GARY ALAN ROBERSON (M. D.) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does DR. GARY ALAN ROBERSON (M. D.) list a practice location?
Patients near Jackson, Mississippi may find DR. GARY ALAN ROBERSON (M. D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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