Sage Family Medicine, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M6632 Issued in TX

Legal business name

SAGE FAMILY MEDICINE, PA

Practice address

1000 Hesters Crossing
200
Round Rock, TX 78681

Phone

(512) 244-0446

NPI assigned

Jun 22, 2007

Last updated

Mar 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roger Gildersleeve, MDNPI 1770554149

Title

President

Phone

(512) 244-0446

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roger Wesley Gildersleeve, MD

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1770554149
  NPD (past) Authorized official

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1013113463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HESTERS CROSSING",
            "address_2": "200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-244-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HESTERS CROSSING",
            "address_2": "200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-244-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "GILDERSLEEVE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-244-0446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M6632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sacred Heart Community Clinic
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• Safetrans
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• Family Medicine Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.