Active NPI
Charles Alfred Roberts, D.C.
- Chiropractor
- Richmond, IN
National Provider Identifier
1982821286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08000674
- Practice address
- 2835 US Highway 35 N
Richmond, IN 47374-9706 - Phone
- (765) 962-4308
- Fax
- (765) 962-4308
- NPI assigned
- Apr 19, 2007
- 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 | 08000674 | IN | Primary |
Addresses
Primary practice location
2835 US Highway 35 N
Richmond, IN 47374-9706
Mailing address
2835 US Highway 35 N
Richmond, IN 47374-9706
Phone (765) 962-4308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000079299 | Other | IN | BLUE CROSS BLUE SHIELD |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08000674 | IN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Community Health Center | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982821286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2835 US HIGHWAY 35 N",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473749706",
"telephone_number": "765-962-4308",
"fax_number": "765-962-4308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 US HIGHWAY 35 N",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473749706",
"telephone_number": "765-962-4308",
"fax_number": "765-962-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHARLES",
"middle_name": "ALFRED",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08000674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000079299",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.