Travis J Roedocker, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

716 Issued in ND

Practice address

1001 20TH Ave SW
Minot, ND 58701

Phone

(701) 852-0158

Fax

(701) 852-5630

NPI assigned

Jul 12, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiropractic Arts Clinic LLCGroup PAC ID 8325304991, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chiropractic Arts Clinic, LLC

  • Chiropractor
  • Minot, ND
  • NPI 1467964684
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700811148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-0158",
            "fax_number": "701-852-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-0158",
            "fax_number": "701-852-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDOCKER",
        "first_name": "TRAVIS",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PROVIDER #",
            "identifier": "711180",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC MEDICAID",
            "identifier": "10810",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12206",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin H Robertson, LCSW
• Robin Pursifull LLC
• Dominique Robinson
• Cyara Fay Rodriguez, CNA
• Rosendo Rodriguez Jr.
• Tricia Roen Sorenson
• Marie Rogers, CPHT
• Shellsey R Rollings, M.S.CCC
• Maribel Rollins
• Dawn Dynelle Romfo, FNP

• Chiropractor in Minot, ND
• Providers in Minot, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.