MRS. KIMBERLY S ROBERTS (FNP) – Family Nurse Practitioner, NPI 1407210685

MRS. KIMBERLY S ROBERTS (FNP) is a healthcare provider. based in Henderson, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 21131 (TN). The NPI Number for MRS. KIMBERLY S ROBERTS (FNP) is 1407210685

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY S ROBERTS (FNP)
NPI
1407210685
Phone
(731) 989-2829
Address
111 FRONT ST
Enumeration Date
13 April 2016
Last Update Date
9 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7319892829
Graduation Year
2015 (11 years ago)
PAC ID
9931476835
Group Practice PAC ID
7012334873
Professional Enrollment ID
I20170524002722
Address ID
TN383402313HE111XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for MRS. KIMBERLY S ROBERTS (FNP)

  • 111 FRONT ST

    HENDERSON, TN 383402313

    Phone: (731) 989-2829

    Fax: (731) 520-0230

    Type: Mailing

  • 702 S Main St

    Middleton, TN 380523615

    Phone: (731) 989-2829

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $80.

Total Amount is formed as General ($80) + Research ($0) + Ownership ($0) = $80.

Last reported payment date: 2024-11-25 • Largest payer in this snapshot: ABBVIE INC. ($26).

Total Amount

$80

General + Research + Ownership

Payments

4

Total payment records

General Amount

$80

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-25

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: 2017-05-24

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
I20170524002722INurse PractitionerTNTBD

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 38340)

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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: 7012334873View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerTN
Physician AssistantTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

Is there an official ID for MRS. KIMBERLY S ROBERTS (FNP) in U.S. healthcare records?
The official identifier for MRS. KIMBERLY S ROBERTS (FNP) is NPI 1407210685.
Active or inactive — what applies to MRS. KIMBERLY S ROBERTS (FNP)?
You should see MRS. KIMBERLY S ROBERTS (FNP) as active in CMS-hosted NPPES data.
How would a patient describe MRS. KIMBERLY S ROBERTS (FNP)'s focus?
For MRS. KIMBERLY S ROBERTS (FNP), the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. KIMBERLY S ROBERTS (FNP)?
Directory geography for MRS. KIMBERLY S ROBERTS (FNP) centers on Henderson, Tennessee.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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