ROGER K JOHNSON (NPI# 1760584734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760584734 |
| Entity Type | Individual |
| Full Name | ROGER K JOHNSON |
| Credential | M.D. |
| Practice Address |
351 Executive Pkwy Ste M1 Rockford IL 61107-5298 |
| Practice Telephone | 8153958100 |
| Practice Fax Number | 8153958179 |
| Mailing Telephone | 8153958100 |
| Mailing Fax Number | 8153958179 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | IL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 0010100596 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033659818 | Roger D Johnson | Physical Therapy Assistant | 8814 Padie Smt, San Antonio, TX 78251-2585 | 2017-02-28 |
| 1821369919 | Roger Brian Johnson | Internal Medicine | 7595 E Placita Vista Del Bosque, Tucson, AZ 85715-3651 | 2012-01-20 |
| 1417034125 | Roger B Johnson | Family Medicine | 16 E 13th St, Lawrence, KS 66044-3502 | 2006-11-01 |
| 1083791610 | Roger L. Johnson | Counselor | 2800 N. Dallas Parkway, Suite 220, Plano, TX 75093 | 2006-11-01 |
| 1831281013 | Roger Alan Johnson | Podiatrist | 308 S Johnson, Visalia, CA 93291 | 2006-09-28 |
| 1447361605 | Roger Groom Johnson | Dentist | 1103 Nw 67th, Lawton, OK 73505 | 2006-08-31 |
| 1780624742 | Roger F Johnson | Internal Medicine | 901 Saint Marys Dr Ste 200, Evansville, IN 47714 | 2006-06-07 |
| 1215975362 | Roger Dale Johnson | Nurse Practitioner | 207 E Myrtle Ave, Johnson City, TN 37601-4633 | 2006-06-02 |
| 1649278763 | Roger K. Johnson | Optometrist | 1629 Union Ave, Natrona Heights, PA 15065-2134 | 2005-07-12 |
| 1952665002 | Roger D Johnson | Counselor | 112 Pearson, Benton, AR 72015-4436 | 2012-07-03 |
| Street Address |
351 EXECUTIVE PKWY STE M1 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053615054 | Lisa Diane Kehoe | Specialist | 1745 Williamsburg Rd, Rockford, IL 61107-2445 | 2011-01-05 |
| 1134445489 | Sanford Bruce Mer | Specialist | 3008 Spring Creek Rd, Rockford, IL 61107-1061 | 2010-04-12 |
| 1225351935 | Rhiannon Marie Deyoung | Specialist | 8450 Algoma Ave Ne Ste Aaa, Rockford, MI 49341-7508 | 2010-03-09 |
| 1689900169 | Jacqueline Michele Sharp | Specialist | 2204 Arthur Ave, Rockford, IL 61101-5224 | 2009-10-19 |
| 1184869893 | Joseph Gerard Lynch | Specialist | 8081 Ravenrock Rd, Rockford, MN 55373-9394 | 2008-12-09 |
| 1548438344 | Helen Wiedemer Laib | Specialist | 4804 Innsbruck Dr, Rockford, IL 61114-7312 | 2008-02-14 |
| 1962609859 | Sandra Rebecca Hallman | Specialist | 6017 Abington Dr, Rockford, IL 61109-2757 | 2007-07-02 |
| 1558481366 | Mark Theodore Peterson | Specialist | 5712 Newburg Rd, Rockford, IL 61108-6707 | 2007-03-29 |
| 1801913769 | Megan D Lindley | Specialist | 610 Vale Ave, Rockford, IL 61107-4656 | 2007-03-24 |
| 1841335072 | Ob-gyn Associates (rockford) Ltd. | Specialist | 1016 Featherstone Road, Rockford Ambulatory Surgery Center, Rockford, IL 61107 | 2007-02-21 |
| 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.