Active NPI
Daniel Corey Roebuck, D.C.
- Chiropractor
- Ocean Springs, MS
National Provider Identifier
1629223151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1097
- Practice address
- 2725 Bienville Blvd
Ocean Springs, MS 39564-4304 - Phone
- (228) 872-7111
- Fax
- (228) 872-4060
- NPI assigned
- Nov 25, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 1097 | MS | Primary |
Addresses
Primary practice location
2725 Bienville Blvd
Ocean Springs, MS 39564-4304
Mailing address
2725 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-7111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141009001136 | MS | Practitioner - Chiropractic | 0446470652 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2725 Bienville Blvd
Ocean Springs, MS 39564-4304
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rossow Clinic of Ocean Springs PA | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Ocean Springs, MS
- NPI 1992267215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582502400000",
"number": "1629223151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 BIENVILLE BLVD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "39564",
"telephone_number": "228-872-7111",
"fax_number": "228-872-4060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 BIENVILLE BLVD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395644304",
"telephone_number": "228-872-7111",
"fax_number": "228-872-4060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEBUCK",
"first_name": "DANIEL",
"middle_name": "COREY",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-25",
"last_updated": "2020-02-24",
"certification_date": "2020-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MS",
"license": "1097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.