NPIMap

Organization Active NPI

Family Psychiatric Center LLC

  • Psychiatry Physician
  • Kokomo, IN
National Provider Identifier
1245302934
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01023409 Issued in IN
Legal business name
FAMILY PSYCHIATRIC CENTER LLC
Practice address
702 W Alto Rd
Kokomo, IN 46902-4907
Phone
(765) 453-7422
Fax
(765) 453-3773
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Authorized official

Name
Mr. Donald L Roegner Jr., M.D
Title
M.D. Dba
Phone
(765) 453-7422

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X IN
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 20010245 IN
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X IN
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 01023409 IN Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 28095903A IN

Addresses

Primary practice location

702 W Alto Rd
Kokomo, IN 46902-4907

Mailing address

PO Box 6459
Kokomo, IN 46904-6459
Phone (765) 453-7422

Other identifiers 1

IdentifierTypeStateIssuer
100154150AMedicaidIN

Other names 1

  • Donald Roegner MD Doing business as

National Provider Directory

National Provider Directory

Locations

702 W Alto Rd
Kokomo, IN 46902
Phone (765) 453-7422

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1245302934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6459",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469046459",
            "telephone_number": "765-453-7422",
            "fax_number": "765-453-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W ALTO RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024907",
            "telephone_number": "765-453-7422",
            "fax_number": "765-453-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PSYCHIATRIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "ROEGNER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "M.D. DBA",
        "authorized_official_telephone_number": "765-453-7422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010245",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01023409",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28095903A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100154150A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donald Roegner MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.