Roger D Iburg

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 4977 Issued in FL

Practice address

511 Phyllis St
Pensacola, FL 32503-2024

Phone

(850) 477-8874

Fax

(850) 477-8865

NPI assigned

Feb 26, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Association of Healthcare Providers Inc

  • Chiropractor
  • Pensacola, FL
  • NPI 1942344106

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1063548980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PHYLLIS ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032024",
            "telephone_number": "850-477-8874",
            "fax_number": "850-477-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PHYLLIS ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032024",
            "telephone_number": "850-477-8874",
            "fax_number": "850-477-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBURG",
        "first_name": "ROGER",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 4977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y2560",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hygeia Medical Equipment, LLC
• Ian R Day, LLC
• Ias Billing Services PC
• Mudasser Ibrahim, MD
• Sherif Ibrahim, M.D.
• Ideal Optical Inc
• Mackenzie Keir Ikenberry, MS CGC
• Nada Samir Ilia, D.M.D.
• Imaging Center of Pensacola Inc
• John Toby Imm, B.C.O.

• Physical Therapist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.