Individual provider Active NPI

Robert Michael Roaney, MD

  • Family Medicine Physician
  • Woodlake, CA
National Provider Identifier
1023173622
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A19696 Issued in CA
Practice address
201 East Lakeview Avenue
Woodlake, CA 93286-1301
Phone
(559) 564-0100
Fax
(559) 564-8723
NPI assigned
Dec 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A19696 CA Primary

Addresses

Primary practice location

201 East Lakeview Avenue
Woodlake, CA 93286-1301

Mailing address

305 East Center Ave.
Visalia, CA 93291-6331
Phone (559) 737-4700

Other identifiers 1

IdentifierTypeStateIssuer
A196960MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A19696CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1023173622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 EAST CENTER AVE.",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-737-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST LAKEVIEW AVENUE",
            "city": "WOODLAKE",
            "state": "CA",
            "postal_code": "932861301",
            "telephone_number": "559-564-0100",
            "fax_number": "559-564-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROANEY",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-25",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A19696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A196960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.