Active NPI
Matthew Miller Robertson, D.C.
- Chiropractor
- Charlotte, NC
National Provider Identifier
1437199692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2961
- Practice address
- 3121 Springbank LN
Suite B
Charlotte, NC 28226-3346 - Phone
- (704) 541-5353
- Fax
- (704) 541-2131
- NPI assigned
- Jun 7, 2006
- 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 | 2961 | NC | Primary |
Addresses
Primary practice location
3121 Springbank LN
Suite B
Charlotte, NC 28226-3346
Mailing address
3121 Springbank LN
Suite B
Charlotte, NC 28226-3346
Phone (704) 541-5353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89085JJ | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040315000557 | NC | Practitioner - Chiropractic | 6103715388 | Practice locations: Charlotte, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3121 Springbank LN B
Charlotte, NC 28226-3347
Phone (704) 541-5353
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1437199692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3121 SPRINGBANK LN",
"address_2": "SUITE B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282263346",
"telephone_number": "704-541-5353",
"fax_number": "704-541-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 SPRINGBANK LN",
"address_2": "SUITE B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282263346",
"telephone_number": "704-541-5353",
"fax_number": "704-541-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "MATTHEW",
"middle_name": "MILLER",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2961",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89085JJ",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.