Rolla Neurology, Pain & Sleep, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ROLLA NEUROLOGY, PAIN & SLEEP, LLC

Practice address

604 W 6TH St
Suite a
Rolla, MO 65401-2941

Phone

(573) 341-8500

Fax

(573) 341-8581

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Akhtar Choudhary, M.D.

Title

Physician

Phone

(573) 341-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1104073352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W 6TH ST",
            "address_2": "SUITE A",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012941",
            "telephone_number": "573-341-8500",
            "fax_number": "573-341-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 W 6TH ST",
            "address_2": "SUITE A",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012941",
            "telephone_number": "573-341-8500",
            "fax_number": "573-341-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLA NEUROLOGY, PAIN & SLEEP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "CHOUDHARY",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "AKHTAR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "573-341-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207629510",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rolla Dermatology LLC
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• Rolla Ophthalmology Associates, Inc
• Rolla Optical
• Rolla Public Schools
• Rolla Radiology Group, LLC
• Rolla Residential, LLC

• Specialist in Rolla, MO
• Providers in Rolla, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.