Evan Roeder, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

5493 Issued in NC

Practice address

8912 Blakeney Professional Dr Ste 100
Charlotte, NC 28277-6735

Phone

(704) 544-5353

NPI assigned

May 13, 2022

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 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Sports Chiropractic PLLCGroup PAC ID 1254584659, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Carolina Sports Chiropractic PLLC

  • Chiropractor
  • Charlotte, NC
  • NPI 1902034846

  NC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1740927656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E BLAND ST UNIT 3",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036111",
            "telephone_number": "717-649-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8912 BLAKENEY PROFESSIONAL DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776735",
            "telephone_number": "704-544-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "EVAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NC",
            "license": "5493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA",
            "identifier": "5493",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth W Roe, PT
• Kristin Bowles Roe, L.P.C
• La Becky Henri Roe
• Meredith P Roe, MS
• Victoria Roed, CPNP-PC
• Michelle L Roehm, CRNA
• Ashley Ayers Roehrig, RD, LDN
• Philip Roehrs, MD
• Clifford Eric Roemer, M.D.
• Diana Tong Roetting, PA-C

• All providers in Charlotte, NC
• Sports Physician Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.