*FOLLOW UP*
Hi folks, just want to follow up on this issue now that I have everything sorted out. Turns out this issue had "everything" to do with session timers. Here's what I did and why...
Tony's suggestion to change registration timer to 60 seconds was the fix, but after some playing around I was able to understand the issue a little better. I realized there were other timers in the works here, more specifically, firewall session timers. Since these are UDP sessions, finding and setting them can be challenging, especially at the firewall level.
For PFsense - The only way to change UDP session timers is to put the firewall in "conservative" mode. This will, by nature, extend the UDP session timers. Keep in mind, longer session timers mean more system resources.
For Fortigate - set udp-session-timer (default is 180 seconds)
I was trying to avoid IP auth for philosophical reasons (i.e Multi-WAN) so I'm glad this is all worked out now. We have been running solid for a week and averaging over 300 calls a day.
Hope this helps someone else.
--Jim