ANDREW GODFREY ROBERTSON CPNP-PC
NPI 1861148926
Nurse Practitioner - Pediatrics in Jackson, MS

Active since February 28, 2022PECOS Enrolled
2500 N STATE ST, JACKSON, MS 39216(601) 984-1000 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 3, 2025, Feb 28, 2022 (2 updates tracked since 2022).

About Andrew Godfrey Robertson Cpnp-pc NPPES

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

ANDREW GODFREY ROBERTSON CPNP-PC (NPI 1861148926) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (906479) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1861148926
Entity TypeIndividualMale
Primary Taxonomy363LP0200X
Provider Legal NameANDREW GODFREY ROBERTSONCredential: CPNP-PC
Location Address2500 N STATE STJackson, MS 39216-4500
Mailing Address2500 N State StJackson, MS 39216-4500
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 28, 2022
Last NPPES UpdateJune 3, 20252 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
NPI 1861148926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in MS · 906479
Also ListedRegistered NurseTaxonomy 163W00000X · License 900730 (MS)
2500 N STATE ST, Jackson, MS 39216

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Andrew Godfrey Robertson Cpnp-pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557875705
PECOS Enrollment IDI20250709002328
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Ophthalmology
2500 N STATE ST, STE B329
JACKSON, MS 39216
Pharmacist (Psychiatric)
2500 N STATE ST
JACKSON, MS 39216
Rehabilitation Unit
2500 N STATE ST
JACKSON, MS 39216
Otolaryngology
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY
JACKSON, MS 39216
Dentist
2500 N STATE ST
JACKSON, MS 39216
Anesthesiology (Pediatric Anesthesiology)
2500 N STATE ST, DEPT. OF ANESTHESIOLOGY
JACKSON, MS 39216
Dentist
2500 N STATE ST, UNIVERSITY OF MISSISSIPPI SCHOOL OF DENTISTRY
JACKSON, MS 39216
Psychologist (Clinical)
2500 N STATE ST
JACKSON, MS 39216

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861148926, enumerated as an "individual" on February 28, 2022.

The provider is located at 2500 N STATE ST JACKSON, MS 39216 and the phone number is (601) 984-1000.

Nurse Practitioner with taxonomy code 363LP0200X and a focus in Pediatrics.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama, Molina. Please consult your insurance carrier or call the provider to verify.