DR. ROGER PEARSON (NPI# 1104809177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104809177 |
| Entity Type | Individual |
| Full Name | DR. ROGER PEARSON |
| Credential | DDS |
| Practice Address |
1200 W State St Rockford IL 61102-2112 |
| Mailing Address |
1312 Creekwood Cir Rockford IL 61108-1531 |
| Practice Telephone | 8154901600 |
| Mailing Telephone | 8153980596 |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DOREL | 1003292 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437438595 | Roger Comstock Pearson Jr. | Social Worker | 21350 W 153rd St, Olathe, KS 66061-5413 | 2011-08-08 |
| Street Address |
1200 W STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61102-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780680827 | Barbara B Morgan | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2005-06-23 |
| 1588271894 | Angela Siebold | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-30 |
| 1942814322 | Jacqueline Paige Cabrera | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-03 |
| 1285250951 | Aaleeyah Pringle Alim | Dentist | 1200 W State St, Rockford, IL 61102-2112 | 2020-06-18 |
| 1639792419 | Jessica Lauren Cole | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-05-27 |
| 1437779071 | Christian Murillo | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-04-23 |
| 1033746573 | Erin Ashleigh Donahue | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-03-25 |
| 1609406008 | Marissa Dreger | Family Medicine | 1200 W State St, Rockford, IL 61102-2112 | 2020-01-24 |
| 1962041657 | Sabrina Lee Puvalowski | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-12-30 |
| 1932741717 | Jacob Dalton Boehm | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205115383 | Renee Lynn Keeney | Advanced Practice Midwife | 1200 W. State Street, Crusader Community Health, Rockford, IL 61102 | 2011-08-08 |
| 1689895906 | Linda Lou O'reilly | Local Education Agency (LEA) | 1515 S. Meridian Road, Rockford, IL 61102 | 2007-05-02 |
| 1801012992 | Jennifer Anne Boyd | Developmental Therapist | Nia 1515 S. Meridian Rd., Rockford, IL 61102 | 2007-04-17 |
| 1609173434 | Kellie J Gibbons | Registered Nurse | 650 W State Street, Winnebago County Jail Medical Unit, Rockford, IL 61102-0000 | 2011-02-14 |
| 1275708752 | Mercy Ambulance Service LLC | Ambulance | 1025 Campton Dr, Rockford, IL 61102-1066 | 2008-04-25 |
| 1417448424 | Brittany Nicole Lambert | Student in an Organized Health Care Education/Training Program | 8040 Towermont Dr, Rockford, IL 61102-1080 | 2018-05-24 |
| 1164490132 | Harlan Johnson | Counselor | 852 Lakewood Dr, Rockford, IL 61102-1228 | 2006-03-08 |
| 1184137283 | Gail Mary Swenson | Speech-Language Pathologist | 730 Lincoln Park Blvd, Rockford, IL 61102-1429 | 2017-11-10 |
| 1659316339 | Institute of Family Care | Home Health | 417 S Pierpont Ave, Rockford, IL 61102-1656 | 2006-06-18 |
| 1861851438 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1200 W State St Ste 102, Rockford, IL 61102-2112 | 2016-02-11 |
| Find all providers in zip 61102 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1295192144 | Woolery Dental P.C. | Dentist | 5301 E State St Ste 306, Rockford, IL 61108-2390 | 2016-01-23 |
| 1467849679 | Christopher Lee Greenwaldt | Dentist | 845 S Perryville Rd Unit 127, Rockford, IL 61108-4340 | 2015-04-26 |
| 1427463785 | Yong Woo Lee | Dentist | 7310 Walton St, Rockford, IL 61108-4614 | 2014-06-25 |
| 1750624110 | Austriaco Dental Associates LLC | Dentist | 7310 Walton St Ste A, Rockford, IL 61108-4614 | 2013-04-03 |
| 1609173749 | Kathryn Ashley Edgcomb | Dentist | 1376 Reid Farm Rd, Rockford, IL 61107-2679 | 2011-02-25 |
| 1629393962 | Affordable Dentistry Today | Dentist | 5819 E Riverside Blvd # 21, Rockford, IL 61114-4963 | 2010-03-30 |
| 1346563525 | Modern Dental of Rockford LLC | Dentist | 1321 Sandy Hollow Rd, Rockford, IL 61109-2120 | 2010-03-02 |
| 1063667079 | Wilson Dental, PC | Dentist | 610 E. Division, Rockford, MI 49341 | 2008-11-19 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.