Harvey James Roeder III, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15720 Issued in AR

Practice address

1401 SE Walton Blvd
113
Bentonville, AR 72712-3759

Phone

(479) 254-3999

Fax

(479) 254-3998

NPI assigned

Aug 30, 2010

Last updated

Mar 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Chip Roeder Other name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Sports Medicine

Education

Logan College of Chiropractic, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Impact Health

  • Sports Physician Chiropractor
  • Bentonville, AR
  • NPI 1417214230
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1710293618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 S 67TH ST",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "727188460",
            "telephone_number": "479-254-3999",
            "fax_number": "479-254-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SE WALTON BLVD",
            "address_2": "113",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123759",
            "telephone_number": "479-254-3999",
            "fax_number": "479-254-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "HARVEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AR",
            "license": "15720",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "15720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF CHIROPRACTIC EXAMINERS",
            "identifier": "ACUPUNCTURE",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIP",
            "last_name": "ROEDER",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tondalaya Rochell
• Rodger C. Dickinson, Jr., M.D., PA
• Kristen Rodgers
• Melissa A Rodgers
• Wanda Rodinsky, LCSW
• Alyssa Kay Turner Rogers, LCSW
• Bill B Rogers, LPN
• Earl Rogers, RN/MHPP
• Katherine Rogers, EDS, LPC
• Kayla Rogers, COTA/L

• Chiropractor in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.