Active NPI
Roger Anthony Dreyling, M.D.
- Family Medicine Physician
- Port Charlotte, FL
National Provider Identifier
1316344856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17709
- Practice address
- 2511 Pebble Creek PL
Port Charlotte, FL 33948-1684 - Phone
- (941) 391-5649
- NPI assigned
- Nov 27, 2014
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17709 | MN | Primary |
Addresses
Primary practice location
2511 Pebble Creek PL
Port Charlotte, FL 33948-1684
Mailing address
2511 Pebble Creek PL
Port Charlotte, FL 33948-1684
Phone (941) 391-5649
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17709 | Other | PHYSICIAN LICENSE |
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 |
|---|---|---|---|
| 17709 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417046400000",
"number": "1316344856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 PEBBLE CREEK PL",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339481684",
"telephone_number": "941-391-5649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2511 PEBBLE CREEK PL",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339481684",
"telephone_number": "941-391-5649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREYLING",
"first_name": "ROGER",
"middle_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-27",
"last_updated": "2014-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "17709",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN LICENSE",
"identifier": "17709",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.