AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1306696067

AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) is a healthcare provider. based in Kingston, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, CNP, PMHNP-BC. They hold a License No. 217309 (OK). The NPI Number for AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) is 1306696067

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA ROBERTSON (APRN, CNP, PMHNP-BC)
NPI
1306696067
Phone
(580) 740-4053
Address
PO BOX 1701
Enumeration Date
25 March 2024
Last Update Date
25 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5807404053
Graduation Year
2024 (2 years ago)
PAC ID
5890237952
Group Practice PAC ID
3173877362
Professional Enrollment ID
I20240605001073
Address ID
OK747012997DU2701XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for AMANDA ROBERTSON (APRN, CNP, PMHNP-BC)

  • PO BOX 1701

    KINGSTON, OK 734391701

    Phone: (580) 740-4053

    Type: Mailing

  • 2701 W UNIVERSITY BLVD

    DURANT, OK 747012997

    Phone: (580) 740-4053

    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: 2024-06-05

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
I20240605001073INurse PractitionerOKTBD

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 73439)

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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: 3173877362View full group profile
NameSpecialtyState
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Clinical Social WorkerOK
Mental Health CounselorOK
Clinical Social WorkerOK
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

How do I look up AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) by NPI?
Use NPI 1306696067 when you need to reference AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) in forms, claims, or directories.
Is AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) currently active in the NPI registry?
CMS-published data lists AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) as an active registrant.
Does AMANDA ROBERTSON (APRN, CNP, PMHNP-BC) list a primary specialty?
If you are matching referrals, note Psychiatric/Mental Health Nurse Practitioner for AMANDA ROBERTSON (APRN, CNP, PMHNP-BC). Clinical services aligned with this taxonomy classification.
Where does public data place AMANDA ROBERTSON (APRN, CNP, PMHNP-BC)?
The snapshot lists Kingston, Oklahoma for AMANDA ROBERTSON (APRN, CNP, PMHNP-BC); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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