Organization Active NPI

Roger L. Fife, M.D., Inc

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1003860586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROGER L. FIFE, M.D., INC
Practice address
780 West Olive Avenue
Suite 104
Merced, CA 95348-2437
Phone
(209) 723-9879
Fax
(209) 384-9027
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roger L. Fife, M.D.
Title
President
Phone
(209) 723-9879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

780 West Olive Avenue
Suite 104
Merced, CA 95348-2437

Mailing address

780 West Olive Avenue
Suite 104
Merced, CA 95348-2437
Phone (209) 723-9879

Other identifiers 1

IdentifierTypeStateIssuer
00A341050MedicaidCA

National Provider Directory

National Provider Directory

Locations

780 W Olive Ave
Ste 104
Merced, CA 95348
Phone (209) 349-1896

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003860586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 WEST OLIVE AVENUE",
            "address_2": "SUITE 104",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482437",
            "telephone_number": "209-723-9879",
            "fax_number": "209-384-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 WEST OLIVE AVENUE",
            "address_2": "SUITE 104",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482437",
            "telephone_number": "209-723-9879",
            "fax_number": "209-384-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER L. FIFE, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FIFE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-723-9879",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A341050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.