MR. JUSTIN M ROBERTSON
NPI 1669804803
Social Worker in Walnut Ridge, AR

Q: What is Justin Robertson's NPI number?

The NPI number for Justin Robertson is 1669804803. It was assigned to this individual provider in the NPPES registry on July 30, 2013.

Q: What is Justin Robertson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Robertson was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 30, 2013PECOS Enrolled

1425 W MAIN ST, WALNUT RIDGE, AR 72476(870) 886-5303(870) 886-7002 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 13, 2021, Jun 20, 2018, Jul 25, 2017 (3 updates tracked since 2017).

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About Mr. Justin M Robertson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JUSTIN M ROBERTSON (NPI 1669804803) is an individual social worker in Walnut Ridge, Arkansas and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1669804803

Entity TypeIndividualMale

Primary Taxonomy104100000X

Provider Legal NameMR. JUSTIN M ROBERTSON

Location Address1425 W MAIN STWalnut Ridge, AR 72476-1431

Mailing Address1815 Pleasant Grove RdJonesboro, AR 72405-7870 · (870) 933-6886 · Fax (870) 336-1339

Phone(870) 886-5303

Fax(870) 886-7002

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJuly 30, 2013

Last NPPES UpdateNovember 29, 20233 updates tracked since enumeration

NPPES CertifiedApril 13, 2021

✔ NPI 1669804803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

1425 W MAIN ST, Walnut Ridge, AR 72476

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Justin M Robertson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729554019

PECOS Enrollment IDI20260415000406

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAWNA NICHOLAS LPN

Case Manager/Care Coordinator