Active NPI
Roger F Landry, M.D.
- Aerospace Medicine Physician
- Dallas, PA
National Provider Identifier
1306980099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- 59900
- Practice address
- 120 Upper Demunds Rd
Dallas, PA 18612-8811 - Phone
- (570) 947-5401
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 59900 | MA | Primary |
Addresses
Primary practice location
120 Upper Demunds Rd
Dallas, PA 18612-8811
Mailing address
120 Upper Demunds Rd
Dallas, PA 18612-8811
Phone (570) 947-5401
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59900 | MA | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306980099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 UPPER DEMUNDS RD",
"city": "DALLAS",
"state": "PA",
"postal_code": "186128811",
"telephone_number": "570-947-5401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 UPPER DEMUNDS RD",
"city": "DALLAS",
"state": "PA",
"postal_code": "186128811",
"telephone_number": "570-947-5401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "ROGER",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "MA",
"license": "59900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, PA
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.