Organization Active NPI

McRoberts Chiropractic, LLC

  • Chiropractor
  • Verona, WI
National Provider Identifier
1740307438
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3755-012 Issued in WI
Legal business name
MCROBERTS CHIROPRACTIC, LLC
Practice address
951 Kimball Lane
Suite 122
Verona, WI 53593
Phone
(608) 848-0058
Fax
(608) 848-0059
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Dr. Tim Edward McRoberts, D.C.
Title
Owner
Phone
(608) 848-0058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3755-012 WI Primary

Addresses

Primary practice location

951 Kimball Lane
Suite 122
Verona, WI 53593

Mailing address

951 Kimball Lane
Suite 122
Verona, WI 53593
Phone (608) 848-0058

Other identifiers 2

IdentifierTypeStateIssuer
1437116993OtherWINPI INDIVIDUAL
38934100MedicaidWI

National Provider Directory

National Provider Directory

Locations

951 Kimball Ln
Ste 122
Verona, WI 53593
Phone (608) 692-9442

Practitioners & affiliated clinicians

Practitioners 2

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1740307438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 KIMBALL LANE",
            "address_2": "SUITE 122",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "53593",
            "telephone_number": "608-848-0058",
            "fax_number": "608-848-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 KIMBALL LANE",
            "address_2": "SUITE 122",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "53593",
            "telephone_number": "608-848-0058",
            "fax_number": "608-848-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCROBERTS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "MCROBERTS",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-848-0058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3755-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1437116993",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38934100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.