Carol Ann Royer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01030119 Issued in IN

Practice address

611 E. Douglas Rd.
Suite 128
Mishawaka, IN 46545-1464

Phone

(574) 335-6210

Fax

(574) 335-6211

NPI assigned

Jan 25, 2007

Last updated

Dec 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1235284357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8016",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466608016",
            "telephone_number": "574-271-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E. DOUGLAS RD.",
            "address_2": "SUITE 128",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-335-6210",
            "fax_number": "574-335-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYER",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01030119",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "IN",
            "license": "01030119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091090B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole E Rose
• Amy A Rosen, LMHC
• Jacob Roshanmanesh
• Roushe Dialysis LLC (Mishawaka Dialysis)
• Steven A. Rowe
• April Rozycki, FNP-BC
• Todd W Rozycki, MD
• Ellis David Rudan Jr.
• David Luke Rudolph
• Daniel Rudzinski, M.D.

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.