Roger L Roark, MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20190 Issued in NC

Legal business name

ROGER L ROARK, MD PA

Practice address

555 Kitchings Dr Ste C
Statesville, NC 28677-3576

Phone

(704) 873-2516

Fax

(704) 873-1431

NPI assigned

Aug 27, 2010

Organization subpart

No

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

Authorized official

Name

Roger Lee Roark, MD

Title

Owner

Phone

(704) 873-2516

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1023324027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 KITCHINGS DR STE C",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773576",
            "telephone_number": "704-873-2516",
            "fax_number": "704-873-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 KITCHINGS DR STE C",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773576",
            "telephone_number": "704-873-2516",
            "fax_number": "704-873-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER L ROARK, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-873-2516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "20190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "71981",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79-71981",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary T Robinson, MD
• Stephanie Lynn Robison, APRN-CNP
• Maribel Robles, SLP-CCC
• Dustin Thomas Roe, PHARMD
• Katherine Ashe Roethling, LCSWA
• Ashley Card Rogers, RN
• Camilla Rogers, PH.D.
• Lyndsay Rogers
• Sonya Lynn Rogers, FNP
• Donnielle Lauren Rome-Martin, OTR/L

• Surgery Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.