Active NPI
Thomas Gregory Rooker, D.D.S.
- Dentist
- Jefferson, WI
National Provider Identifier
1053325522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1647 G
- Practice address
- 116 E Milwaukee St
Jefferson, WI 53549-1636 - Phone
- (920) 674-5225
- NPI assigned
- Jul 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1647 G | WI | Primary |
Addresses
Primary practice location
116 E Milwaukee St
Jefferson, WI 53549-1636
Mailing address
116 E Milwaukee St
Jefferson, WI 53549-1636
Phone (920) 674-5225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33550700 | Medicaid | WI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1647 G | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053325522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 E MILWAUKEE ST",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491636",
"telephone_number": "920-674-5225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 E MILWAUKEE ST",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491636",
"telephone_number": "920-674-5225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOKER",
"first_name": "THOMAS",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1647 G",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33550700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.