Active NPI
Chad Roberts, PT
- Physical Therapist
- Palm Coast, FL
National Provider Identifier
1326098690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT19497
- Practice address
- 50 Town CT
Palm Coast, FL 32164-2589 - Phone
- (386) 313-5974
- Fax
- (866) 647-2045
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT007632 | GA | |
| Physical Therapist | 225100000X | PT19497 | FL | Primary |
Addresses
Primary practice location
50 Town CT
Palm Coast, FL 32164-2589
Mailing address
PO Box 1975
Rome, GA 30162-1975
Phone (706) 236-2755
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 975142262A | Medicaid | GA | |
| 975142262C | Medicaid | GA | |
| P00316287 | Other | GA | RR MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT007632 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Rehabilitation and Consulting | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Rome, GA
- NPI 1174518682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407110400000",
"number": "1326098690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1975",
"city": "ROME",
"state": "GA",
"postal_code": "301621975",
"telephone_number": "706-236-2755",
"fax_number": "866-647-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 TOWN CT",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321642589",
"telephone_number": "386-313-5974",
"fax_number": "866-647-2045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHAD",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2014-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT007632",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT19497",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "975142262A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "975142262C",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00316287",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.