ROGELIO L BAUTISTA (NPI# 1164414660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164414660 |
| Entity Type | Individual |
| Full Name | ROGELIO L BAUTISTA |
| Credential | M.D. |
| Practice Address |
1201 N Rutherford St Macon MO 63552-2020 |
| Practice Telephone | 6603858900 |
| Practice Fax Number | 6603858708 |
| Mailing Telephone | 6603858900 |
| Mailing Fax Number | 6603858708 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 33051 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | TRAVELERS RR MEDICARE | 022155151 | 01 |
| MO | ANTHEM BCBS | 20245 | 01 |
| MO | 200148807 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699117002 | Rogelio Bautista | Physical Therapist | 3703 Lindbergh St, San Diego, CA 92154-1654 | 2013-07-25 |
| Street Address |
1201 N RUTHERFORD ST |
| City | MACON |
| State | MO |
| Zip Code | 63552-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750387163 | Nora Marie Hockman-mcdowell | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2005-06-22 |
| 1942845375 | Emily Kerns | Physician Assistant | 1201 N Rutherford St, Macon, MO 63552-2020 | 2019-11-08 |
| 1508417650 | Jamie Lynne Oliver | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2019-09-20 |
| 1437666872 | Macon County Samaritan Hospital | Clinic/Center | 1201 N Rutherford St, Macon, MO 63552-2020 | 2018-01-08 |
| 1437552213 | Krystal Barnett | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2014-10-07 |
| 1558651794 | Lisa Michelle Mayes | Family Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2011-04-08 |
| 1114195187 | Paula G Barr | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2008-02-13 |
| 1184744765 | Bradley Robert Freidel | Internal Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2007-03-29 |
| 1891734505 | Macon County Samaritan Hospital | Clinic/Center | 1201 N Rutherford St, Macon, MO 63552-2020 | 2006-06-06 |
| 1952340663 | Julie L Burdin | Family Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2006-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1629035084 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 1105 N Rutherford St, Macon, MO 63552 | 2006-04-28 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063054237 | Stacey M Lowe | Surgery | 146 Wesleyan Way, Macon, GA 31210-4400 | 2019-10-09 |
| 1871058933 | Central Georgia Vascular Solutions | Surgery | 688 Walnut St Ste 201, Macon, GA 31201-0316 | 2019-02-04 |
| 1780103879 | Gurijala Ramesh Ramayya | Surgery | 215 Autumn Trace Ct, Macon, GA 31210-8024 | 2017-09-11 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1437594132 | Icu Specialists, LLC | Surgery | 656 Monticlair Dr, Macon, GA 31210-4432 | 2013-05-08 |
| 1164611331 | Hany N Atalah | Surgery | 4801 Oxford Rd, Macon, GA 31210-3039 | 2007-10-23 |
| 1649495870 | William Thomas Carrigan | Surgery | 121 Wolf Creek Dr N, Macon, GA 31210-9002 | 2007-04-14 |
| 1649341033 | Donald W Rhame | Surgery | 700 Spring St, Ste 300, Macon, GA 31201-2146 | 2006-11-10 |
| 1437184306 | John Thomas Williams Iv | Surgery | 870 High St, Macon, GA 31213-0001 | 2006-07-11 |
| 1629002365 | Thomas C Woodyard | Surgery | 330 Hospital Dr Bldg C Ste 315, Macon, GA 31217 | 2006-07-10 |
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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.