Organization Active NPI

Dr. Edwin Roberts Chiropractic, PLC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1669727350
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR. EDWIN ROBERTS CHIROPRACTIC, PLC
Practice address
4469 Mobile Hwy
Pensacola, FL 32506-8241
Phone
(850) 572-5329
NPI assigned
Jul 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Edwin Paul Roberts, DCNPI 1386648376
Title
Pres
Phone
(850) 572-5329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4469 Mobile Hwy
Pensacola, FL 32506-8241

Mailing address

4469 Mobile Hwy
Pensacola, FL 32506-8241
Phone (850) 572-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130212000297 FL Part B Supplier - Clinic/Group Practice 3678727039 Receives reassigned benefits from 1 practitioner
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

4469 Mobile Hwy
Pensacola, FL 32506
Phone (850) 572-5329

4469 Mobile Hwy
Ste D
Pensacola, FL 32506
Phone (850) 912-4155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1669727350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4469 MOBILE HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325068241",
            "telephone_number": "850-572-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 MOBILE HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325068241",
            "telephone_number": "850-572-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. EDWIN ROBERTS CHIROPRACTIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "850-572-5329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.

Verify at the official NPI Registry.