Active NPI
Roger Q. Landers III, MD
- Anatomic Pathology & Clinical Pathology Physician
- Albany, OR
National Provider Identifier
1184845596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 18183
- Practice address
- 1046 6TH Ave SW
Albany, OR 97321-1916 - Phone
- (541) 812-4000
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 18183 | OR | Primary |
Addresses
Primary practice location
1046 6TH Ave SW
Albany, OR 97321-1916
Mailing address
7772 Pudding Creek Dr SE
Salem, OR 97301-8907
Phone (503) 363-5594
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18183 | OR | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184845596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7772 PUDDING CREEK DR SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973018907",
"telephone_number": "503-363-5594",
"fax_number": "503-588-3255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1046 6TH AVE SW",
"city": "ALBANY",
"state": "OR",
"postal_code": "973211916",
"telephone_number": "541-812-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDERS",
"first_name": "ROGER",
"middle_name": "Q.",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OR",
"license": "18183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.