Robert Lane Rogers, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME41071 Issued in FL

Practice address

999 Mar Walt Drive
White-Wilson East Building
Fort Walton Beach, FL 32547

Phone

(850) 863-8255

Fax

(850) 862-7965

NPI assigned

Dec 13, 2005

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1073598983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 MAR WALT DRIVE",
            "address_2": "EAST BUILDING",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-8255",
            "fax_number": "850-862-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 MAR WALT DRIVE",
            "address_2": "WHITE-WILSON EAST BUILDING",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-8255",
            "fax_number": "850-862-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ROBERT",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME41071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069716800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "47176",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Camille Rodriguez, DO
• Fabian Rodriguez, NP
• Tiana Rodriguez
• Wilson Rodriguez Jr.
• Alun Morgan Rogers, DC
• Walter Rogers, R.PH.
• Sandee Rohrer
• Lea Roltsch
• Mikaela Nicole Romain, DO
• Billie Nicole Root

• Surgery Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.