Active NPI
Gregory Alan Roberts, DC
- Chiropractor
- Lakeville, MN
National Provider Identifier
1235549106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5936
- Practice address
- 20153 Holister LN
Lakeville, MN 55044-6866 - Phone
- (651) 800-1318
- NPI assigned
- May 1, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5936 | MN | Primary |
Addresses
Primary practice location
20153 Holister LN
Lakeville, MN 55044-6866
Mailing address
20153 Holister LN
Lakeville, MN 55044-6866
Phone (651) 800-1318
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5936 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398902400000",
"number": "1235549106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20153 HOLISTER LN",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550446866",
"telephone_number": "651-800-1318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20153 HOLISTER LN",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550446866",
"telephone_number": "651-800-1318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "GREGORY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-01",
"last_updated": "2014-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.