Gordon Lee Roberts, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

GR004365 Issued in MI

Practice address

3494 M-40
Hamilton, MI 49419

Phone

(269) 751-2670

Fax

(269) 751-2680

NPI assigned

Jul 13, 2006

Last updated

Oct 16, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr Gordon L Roberts PLLC

  • Chiropractor
  • Hamilton, MI
  • NPI 1871789347
  Authorized official Same address or phone

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1437174273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3494 M-40",
            "city": "HAMILTON",
            "state": "MI",
            "postal_code": "49419",
            "telephone_number": "269-751-2670",
            "fax_number": "269-751-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3494 M-40",
            "city": "HAMILTON",
            "state": "MI",
            "postal_code": "49419",
            "telephone_number": "269-751-2670",
            "fax_number": "269-751-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "GORDON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "GR004365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4718950",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Hamilton, MI
• Providers in Hamilton, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.