Nikki Faye Roberts, MSN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Johnson City, Tennessee. Her current practice location is
508 Princeton Rd Ste 403, Johnson City, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(888) 214-2144.
Nikki Faye Roberts is licensed to practice in Tennessee (license number 20757) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023477601.
Healthcare Provider's Profile
| Full Name | Nikki Faye Roberts |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 508 Princeton Rd Ste 403, Johnson City, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1023477601
- Provider Enumeration Date: 02/11/2016
- Last Update Date: 05/22/2026
Medicare PECOS Information:
- PECOS PAC ID: 0941506174
- Enrollment ID: I20160314001693
Medical Identifiers
Medical identifiers for Nikki Faye Roberts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023477601 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 20757 (Tennessee) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 182482 (Tennessee) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | 182482 (Tennessee) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nikki Faye Roberts allows following entities to bill medicare on her behalf.
| Entity Name | Revitalist |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073168241
PECOS PAC ID: 6800295650
Enrollment ID: O20210527000088 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nikki Faye Roberts is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nikki Faye Roberts, MSN
119 Mandolin Dr,
Winter Haven, FL 33884-3581
Ph: (888) 214-2144 | Nikki Faye Roberts, MSN
508 Princeton Rd Ste 403,
Johnson City, TN 37601-2064
Ph: (888) 214-2144 |
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