Gerald D Robertson, DC

Primary specialty

Pediatric ChiropractorTaxonomy code 111NP0017X

License

2020025322 Issued in MO

Practice address

1566 S Odell Ave
Marshall, MO 65340

Phone

(660) 886-5850

Fax

(660) 886-7333

NPI assigned

Jul 15, 2019

Last updated

Aug 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• True Life Chiropractic, LLC

  • Chiropractor
  • Marshall, MO
  • NPI 1003778705
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1336791847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 S ODELL AVE",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "65340",
            "telephone_number": "660-886-5850",
            "fax_number": "660-886-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 S ODELL AVE",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "65340",
            "telephone_number": "660-886-5850",
            "fax_number": "660-886-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GERALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CO",
            "license": "CHR.0008010",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "MO",
            "license": "2020025322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regional Health Care Clinic, Inc. (Katy Trail - Marshall School)
• Misty Relos, MA, LPC, NCC
• Ronald Renard, PT
• Norberto Restituto, MD
• Morgan Renae Ritchie, MS, CCC-SLP
• Shirley Ruth Robertson, M.A., L.P.C, N.C.C
• Jonathan Quentin Robinson, PHARMD
• Marvin Andrew Roehrs, PHARMACIS
• Rachelle Marie Rogers, NP
• Jared Karl Romney, D.O.

• Pediatric Chiropractor in Marshall, MO
• Providers in Marshall, MO by specialty
• Pediatric Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.