Individual provider Active NPI

Ray E Rollins, D.O.

  • Family Medicine Physician
  • Sunnyvale, TX
National Provider Identifier
1205921038
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G5552 Issued in TX
Practice address
3635 N. Beltline Rd
Suite 110
Sunnyvale, TX 75182
Phone
(972) 216-1500
Fax
(972) 216-1300
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G5552 TX Primary

Addresses

Primary practice location

3635 N. Beltline Rd
Suite 110
Sunnyvale, TX 75182

Mailing address

3635 N. Beltline Rd
Suite 110
Sunnyvale, TX 75182
Phone (972) 216-1500

Other identifiers 1

IdentifierTypeStateIssuer
111498505MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080201000102 TX Practitioner - Family Practice 7719069582 Practice locations: Sunnyvale, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1205921038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 N. BELTLINE RD",
            "address_2": "SUITE 110",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "75182",
            "telephone_number": "972-216-1500",
            "fax_number": "972-216-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 N. BELTLINE RD",
            "address_2": "SUITE 110",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "75182",
            "telephone_number": "972-216-1500",
            "fax_number": "972-216-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "RAY",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G5552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111498505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, TX

Sources for this page

Verify at the official NPI Registry.