Individual provider Active NPI

Christopher Bernard Roecker, DC

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1144877093
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007339 Issued in IA
Practice address
1000 Brady St
Davenport, IA 52803-5214
Phone
(712) 249-7701
NPI assigned
Aug 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 007339 IA
Orthopedic Chiropractor 111NX0800X 007339 IA
Chiropractor 111N00000X 007339 IA Primary

Addresses

Primary practice location

1000 Brady St
Davenport, IA 52803-5214

Mailing address

1000 Brady St
Davenport, IA 52803-5214
Phone (712) 249-7011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007339IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1144877093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035214",
            "telephone_number": "712-249-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035214",
            "telephone_number": "712-249-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROECKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "007339",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IA",
            "license": "007339",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.