Active NPI
Jeffrey Alan Roberts, D.C.
- Chiropractor
- Lebanon, KY
National Provider Identifier
1386647071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4427
- Practice address
- 496 W Main St
Lebanon, KY 40033-1362 - Phone
- (270) 692-6555
- Fax
- (270) 692-5751
- NPI assigned
- May 27, 2005
- 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 | 4427 | KY | Primary |
Addresses
Primary practice location
496 W Main St
Lebanon, KY 40033-1362
Mailing address
496 W Main St
Lebanon, KY 40033-1362
Phone (270) 692-6555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060112000516 | KY | Practitioner - Chiropractic | 7214950575 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4427 | KY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205971200000",
"number": "1386647071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 W MAIN ST",
"city": "LEBANON",
"state": "KY",
"postal_code": "400331362",
"telephone_number": "270-692-6555",
"fax_number": "270-692-5751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 W MAIN ST",
"city": "LEBANON",
"state": "KY",
"postal_code": "400331362",
"telephone_number": "270-692-6555",
"fax_number": "270-692-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2008-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "4427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.