Accident and Injury Center of North County PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2001017247 Issued in MO

Legal business name

ACCIDENT AND INJURY CENTER OF NORTH COUNTY PC

Practice address

11405 New Halls Ferry Rd
Florissant, MO 63033-7031

Phone

(314) 838-6070

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ricky A Roberts, D.C.

Title

Owner/President

Phone

(314) 838-6070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Leon Roberts, D.C.

  • Chiropractor
  • Saint Louis, MO
  • NPI 1497050553

  MO

  Medicare reassignment

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1942544010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 NEW HALLS FERRY RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630337031",
            "telephone_number": "314-838-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11405 NEW HALLS FERRY RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630337031",
            "telephone_number": "314-838-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCIDENT AND INJURY CENTER OF NORTH COUNTY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "314-838-6070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2001017247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Florissant, MO
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.