Active NPI
Kevin A Roberts, DC
- Chiropractor
- Ogden, UT
National Provider Identifier
1952412769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 162482-1202
- Practice address
- 924 24TH St Ste 2
Ogden, UT 84401-2641 - Phone
- (801) 621-1740
- Fax
- (801) 621-7229
- NPI assigned
- Aug 31, 2006
- Last updated
- Oct 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 162482-1202 | UT | Primary |
Addresses
Primary practice location
924 24TH St Ste 2
Ogden, UT 84401-2641
Mailing address
924 24TH St Ste 2
Ogden, UT 84401-2641
Phone (801) 621-1740
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870395551005 | Medicaid | UT | |
| 841630033 | Other | UT | MAILHANDLERS |
| 870395551 | Other | UT | CHP |
| 879470 | Other | UT | FIRST HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162482-1202 | UT | MD | Chiropractor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Ogden, UT
- NPI 1497939276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351123200000",
"number": "1952412769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 24TH ST STE 2",
"city": "OGDEN",
"state": "UT",
"postal_code": "844012641",
"telephone_number": "801-621-1740",
"fax_number": "801-621-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 24TH ST STE 2",
"city": "OGDEN",
"state": "UT",
"postal_code": "844012641",
"telephone_number": "801-621-1740",
"fax_number": "801-621-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KEVIN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "162482-1202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870395551005",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAILHANDLERS",
"identifier": "841630033",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHP",
"identifier": "870395551",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "879470",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.