Active NPI
Jacob Odell Roberts, D.C.
- Chiropractor
- Indianapolis, IN
National Provider Identifier
1871760751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08002512A
- Practice address
- 2413 N Meridian St
Indianapolis, IN 46208 - Phone
- (317) 924-5250
- NPI assigned
- May 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 10798 | TX | |
| Chiropractor | 111N00000X | 08002512A | IN | Primary |
Addresses
Primary practice location
2413 N Meridian St
Indianapolis, IN 46208
Mailing address
2413 N Meridian St
Indianapolis, IN 46208-5854
Phone (317) 924-5250
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002512A | IN | MD | Chiropractor |
| 10798 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1871760751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 N MERIDIAN ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462085854",
"telephone_number": "317-924-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2413 N MERIDIAN ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46208",
"telephone_number": "317-924-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JACOB",
"middle_name": "ODELL",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-10",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "10798",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002512A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.