P Praxis·MD
● Active Type 1 · Individual

Jacquelyn Elaine Roberts, ARNP

Nurse Practitioner·Moultrie, GA· NPI 1801880497 · Enumerated 2005 · 20 years on NPI
Roberts is 1 of 2 nurse practitioner providers in Moultrie and 1 of 107 in Georgia.
NPI age
20 years
Enumerated 2005-09-09
Primary specialty
Nurse Practitioner
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
Not specified
May be part of a larger org

How this provider compares

Across 107 active nurse practitioner providers in Georgia.

NPI age
20 years
↑ 7 yr above median (13 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
25% of peers hold subspecialties

NPI lifetime · 2005 → 2026

2005-09Enumerated in NPPES
2005 2026

Where they practice

Practice location
115 31st Ave Se
Moultrie, GA 317686771
📞 2298901665fax 2299855050
Mailing address
115 31st Ave Se
Moultrie, GA 317686771
📞 2298901665fax 2299855050

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    GA license #RN128424 taxonomy 363LX0001X

Identifiers

TypeValueNotes
05 (GA) 00829617C

Practice context

Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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