NPIMap

Organization Active NPI

Dr Gordon L Roberts PLLC

  • Chiropractor
  • Hamilton, MI
National Provider Identifier
1871789347
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
GR004365 Issued in MI
Legal business name
DR GORDON L ROBERTS PLLC
Practice address
3426 M-40
Hamilton, MI 49419
Phone
(269) 751-2670
Fax
(269) 751-2680
NPI assigned
Sep 19, 2007
Last updated
Feb 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Gordon Lee Roberts, DCNPI 1437174273
Title
Owner
Phone
(269) 751-2670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X GR004365 MI Primary

Addresses

Primary practice location

3426 M-40
Hamilton, MI 49419

Mailing address

3426 M-40
Hamilton, MI 49419
Phone (269) 751-2670

Other identifiers 3

IdentifierTypeStateIssuer
4718950MedicaidMI
650240OtherMIUNITED HEALTH CARE
9502310340OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1871789347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 M-40",
            "city": "HAMILTON",
            "state": "MI",
            "postal_code": "49419",
            "telephone_number": "269-751-2670",
            "fax_number": "269-751-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3426 M-40",
            "city": "HAMILTON",
            "state": "MI",
            "postal_code": "49419",
            "telephone_number": "269-751-2670",
            "fax_number": "269-751-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GORDON L ROBERTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-751-2670",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "GR004365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4718950",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "650240",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9502310340",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.