John Wesley Roberts, D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

CH 5772 Issued in FL

Practice address

5201 Babcock St NE
Suite 1
Palm Bay, FL 32905-4637

Phone

(321) 725-5200

Fax

(321) 725-8770

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326167370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 BABCOCK ST NE",
            "address_2": "SUITE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054637",
            "telephone_number": "321-725-5200",
            "fax_number": "321-725-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 BABCOCK ST NE",
            "address_2": "SUITE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054637",
            "telephone_number": "321-725-5200",
            "fax_number": "321-725-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH 5772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD NU",
            "identifier": "22202",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Road Runner Medical Supplies
• Robert M. Love M.D. PA
• Robert W Underill DMD PA
• Donna Roberts
• John J Roberts, BC-HAS
• Leona Anntonette Robinson-Pierre
• Arlette A. Urbina Robleto, COTA
• Tiffany Gomes Rodrigues, LMT, MMP
• Yuderky Rodriguez Denis
• Chavely Rodriguez

• Nutrition Chiropractor in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Nutrition Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.