Individual provider Active NPI

Clifford William Roberson Jr., MD

  • Orthopaedic Surgery of the Spine Physician
  • Atlanta, GA
National Provider Identifier
1821046715
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
21797 Issued in GA
Practice address
4535 Winters Chapel Rd
Atlanta, GA 30360-2705
Phone
(678) 580-1862
Fax
(678) 909-0659
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 21797 GA Primary

Addresses

Primary practice location

4535 Winters Chapel Rd
Atlanta, GA 30360-2705

Mailing address

4535 Winters Chapel Rd
Atlanta, GA 30360-2705
Phone (678) 580-1862

Other names 1

  • Dr. Clifford W Roberson Jr. Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021797GAMDPharmacist
22760WVMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1821046715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 WINTERS CHAPEL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602705",
            "telephone_number": "678-580-1862",
            "fax_number": "678-909-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 WINTERS CHAPEL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602705",
            "telephone_number": "678-580-1862",
            "fax_number": "678-909-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "CLIFFORD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "21797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLIFFORD",
            "last_name": "ROBERSON",
            "middle_name": "W",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.