NPIMap

Organization Active NPI

Roger J. Wolcott, M.D., P.a.

  • Physical Medicine & Rehabilitation Physician
  • Lubbock, TX
National Provider Identifier
1356521892
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
J4620 Issued in TX
Legal business name
ROGER J. WOLCOTT, M.D., P.A.
Practice address
5902 66TH St Unit B
Lubbock, TX 79424-5933
Phone
(806) 797-2139
Fax
(806) 797-3105
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Janet W Beyer
Title
Office Manager
Phone
(806) 797-2139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X J4620 TX Primary

Addresses

Primary practice location

5902 66TH St Unit B
Lubbock, TX 79424-5933

Mailing address

5902 66TH St Unit B
Lubbock, TX 79424-5933
Phone (806) 797-2139

Other identifiers 3

IdentifierTypeStateIssuer
110687404MedicaidTX
172052601MedicaidTX
00028AAOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050207000286 TX Part B Supplier - Clinic/Group Practice 9335190420 Receives reassigned benefits from 11 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Locations

5902 66th St
Unit B
Lubbock, TX 79424
Phone (806) 797-2139

5902 66th St
Lubbock, TX 79424
Phone (806) 797-2139

4321 Marsha Sharp Fwy
Ste 1
Lubbock, TX 79407
Phone (806) 797-2139

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1356521892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5902 66TH ST UNIT B",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245933",
            "telephone_number": "806-797-2139",
            "fax_number": "806-797-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5902 66TH ST UNIT B",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245933",
            "telephone_number": "806-797-2139",
            "fax_number": "806-797-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER J. WOLCOTT, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "BEYER",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "806-797-2139"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "J4620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110687404",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172052601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00028AA",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.