Individual provider Active NPI

James Daley Robart Jr., DC

  • Chiropractor
  • Potosi, MO
National Provider Identifier
1003981895
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE#6565 Issued in MO
Practice address
912 N Missouri St
Potosi, MO 63664
Phone
(573) 438-7200
Fax
(573) 438-4507
NPI assigned
Nov 21, 2006
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE#6565 MO Primary

Addresses

Primary practice location

912 N Missouri St
Potosi, MO 63664

Mailing address

912 N Missouri St
Potosi, MO 63664-2101
Phone (573) 438-7200

Other identifiers 5

IdentifierTypeStateIssuer
431836615OtherMOAETNA, MERCY, FIRST HEALT
756252300MedicaidMO
431836615OtherMOHEALTHLINK AND PHCSNUMBER
110399OtherMOBCBS AND BLUECHOICE
350044981OtherMORAILROAD MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040724000264 MO Practitioner - Chiropractic 3476533894 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Mines Health CenterGroup PAC ID 3072598143, 19 clinicians

Practice addresses (Care Compare)

1 Southtowne Dr
Potosi, MO 63664-5729
Phone (573) 438-9355

912 N Missouri St
Potosi, MO 63664-2101
Phone (573) 438-7200

PO Box
Suite 761
Potosi, MO 63664-0761

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE#6565MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Great Mines Health Center CurrentSince Sep 29, 2018 Accepting new patients
Great Mines Health Center CurrentSince Sep 29, 2018 Accepting new patients
Southtowne Imaging Center LLC Past Accepting new patients

Locations

1 Southtowne Dr
Potosi, MO 63664
Phone (573) 438-8401

Networks

  • IL PPO Downstate
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHFGDD/Endpoint/IHFGDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1003981895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N MISSOURI ST",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636642101",
            "telephone_number": "573-438-7200",
            "fax_number": "573-438-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N MISSOURI ST",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "63664",
            "telephone_number": "573-438-7200",
            "fax_number": "573-438-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBART JR.",
        "first_name": "JAMES",
        "middle_name": "DALEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE#6565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA, MERCY, FIRST HEALT",
            "identifier": "431836615",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756252300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK AND PHCSNUMBER",
            "identifier": "431836615",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AND BLUECHOICE",
            "identifier": "110399",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "350044981",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potosi, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.