Organization Active NPI

Julia Robertson D.C. LLC

  • Chiropractor
  • Salem, OR
National Provider Identifier
1245720226
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5902 Issued in OR
Legal business name
JULIA ROBERTSON D.C. LLC
Practice address
4666 Commercial St SE
Salem, OR 97302
Phone
(503) 399-7607
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Dr. Julia R Robertson, DC
Title
Owner
Phone
(503) 399-7607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5902 OR Primary

Addresses

Primary practice location

4666 Commercial St SE
Salem, OR 97302

Mailing address

4666 Commercial St SE
Salem, OR 97302-1902

Other names 1

  • Robertson Spinal Rehab and Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180619000765 OR Part B Supplier - Clinic/Group Practice 5092060830 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, OR

National Provider Directory

National Provider Directory

Locations

4666 Commercial St SE
Salem, OR 97302
Phone (203) 399-7607

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1245720226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4666 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4666 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-399-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA ROBERTSON D.C. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-399-7607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robertson Spinal Rehab and Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.