NPIMap

Organization Active NPI

Roberts Chiropractic, Inc.

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1104097690
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12261 Issued in CA
Legal business name
ROBERTS CHIROPRACTIC, INC.
Practice address
1136 Tully Rd Ste 1
Modesto, CA 95350-4994
Phone
(209) 577-1274
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Dr. Douglas Wayne Roberts, D.C.
Title
President
Phone
(209) 577-1274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 12261 CA Primary

Addresses

Primary practice location

1136 Tully Rd Ste 1
Modesto, CA 95350-4994

Mailing address

1136 Tully Rd Ste 1
Modesto, CA 95350-4994
Phone (209) 577-1274

National Provider Directory

National Provider Directory

Locations

1136 Tully Rd
Ste 1
Modesto, CA 95350
Phone (209) 577-1274

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1104097690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 TULLY RD STE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504994",
            "telephone_number": "209-577-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 TULLY RD STE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504994",
            "telephone_number": "209-577-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTS CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-577-1274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "12261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.