Individual provider Active NPI

Roger McGovern, HAD

  • Hearing Instrument Specialist
  • Alton, IL
National Provider Identifier
1083844948
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1942 Issued in IL
Practice address
160 Alton SQ
Alton, IL 62002-5917
Phone
(618) 462-9355
Fax
(618) 465-7388
NPI assigned
Jul 24, 2009
Last updated
Jul 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1942 IL Primary

Addresses

Primary practice location

160 Alton SQ
Alton, IL 62002-5917

Mailing address

5000 Cheshire Pkwy N
Plymouth, MN 55446-4103
Phone (888) 333-9152

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

LicenseStateTypeSpecialty
1942ILMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1083844948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CHESHIRE PKWY N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464103",
            "telephone_number": "888-333-9152",
            "fax_number": "763-268-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALTON SQ",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025917",
            "telephone_number": "618-462-9355",
            "fax_number": "618-465-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "ROGER",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "1942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.