Roger Dane Prock, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15562 Issued in OK

Practice address

9322 E 41St St
Tulsa, OK 74145-3721

Phone

(918) 764-7235

Fax

(918) 764-7229

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063432268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9322 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741453721",
            "telephone_number": "918-764-7235",
            "fax_number": "918-764-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9322 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741453721",
            "telephone_number": "918-764-7235",
            "fax_number": "918-764-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCK",
        "first_name": "ROGER",
        "middle_name": "DANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "15562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Melissa Probst, DNP
• Procare Healing Centers
• Procedural Pain Management LLC
• Jamie Procita
• Meagan Nadean Prock, LCSW
• Shaycoya Proctor
• Productive Counseling Services PLLC
• Professional Anesthesiology Surgical Services, PC
• Professional Dysphagia Specialists
• Professional Hearing Healthcare PC

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.