Individual provider Active NPI

Melissa Roberts, D.C

  • Chiropractor
  • Woodbury, CT
National Provider Identifier
1710355334
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002011 Issued in CT
Practice address
226 Main St N
Woodbury, CT 06798-2918
Phone
(860) 838-1038
Fax
(203) 586-1477
NPI assigned
Sep 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 002011 CT Primary

Addresses

Primary practice location

226 Main St N
Woodbury, CT 06798-2918

Mailing address

226 Main St N
Woodbury, CT 06798-2918
Phone (203) 586-1466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000739 CT Practitioner - Chiropractic 4587964697 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002011CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
J&M Family Chiropractic LLC Chiropractor CurrentSince Oct 22, 2015 Accepting new patients

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Jandm Family Chiropractic LLC 2 clinicians

Practice addresses (Care Compare)

226 Main St N
Woodbury, CT 06798-2983
Phone (203) 586-1466

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1710355334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MAIN ST N",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982918",
            "telephone_number": "203-586-1466",
            "fax_number": "203-586-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MAIN ST N",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982918",
            "telephone_number": "860-838-1038",
            "fax_number": "203-586-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "002011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.