Active NPI
Jesse Leon Roberts, D.C.
- Chiropractor
- Saint Louis, MO
National Provider Identifier
1497050553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2009011872
- Practice address
- 1701 S Florissant Rd
Saint Louis, MO 63121-1131 - Phone
- (314) 522-0042
- NPI assigned
- Jan 21, 2011
- Last updated
- Jan 21, 2011
- 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 | 2009011872 | MO | Primary |
Addresses
Primary practice location
1701 S Florissant Rd
Saint Louis, MO 63121-1131
Mailing address
12495 Old Halls Ferry Rd
Florissant, MO 63033-4201
Phone (314) 330-9474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11405 New Halls Ferry Rd
Florissant, MO 63033-7031
Phone (314) 838-6070
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009011872 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. David a Sciortino, LTD | Chiropractor | Past | Accepting new patients |
| St Louis Medical Center Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Chiropractor
- Florissant, MO
- NPI 1942544010
-
dba Sciortino St Louis Medical Center
- General Practice Physician
- Saint Louis, MO
- NPI 1730576224
Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1497050553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12495 OLD HALLS FERRY RD",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630334201",
"telephone_number": "314-330-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 S FLORISSANT RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631211131",
"telephone_number": "314-522-0042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JESSE",
"middle_name": "LEON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-21",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2009011872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.