Active NPI
Roger E Ordal, CSA
- Surgical Physician Assistant
- Madisonville, KY
National Provider Identifier
1366635963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- SA026
- Practice address
- 200 Clinic Dr
Madisonville, KY 42431-1661 - Phone
- (270) 326-6116
- Fax
- (270) 326-6118
- NPI assigned
- Aug 27, 2007
- Last updated
- Aug 27, 2007
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | SA026 | KY | Primary |
Addresses
Primary practice location
200 Clinic Dr
Madisonville, KY 42431-1661
Mailing address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 326-6116
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA026 | KY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188172800000",
"number": "1366635963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CLINIC DR",
"city": "MADISONVILLE",
"state": "KY",
"postal_code": "424311661",
"telephone_number": "270-326-6116",
"fax_number": "270-326-6118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 CLINIC DR",
"city": "MADISONVILLE",
"state": "KY",
"postal_code": "424311661",
"telephone_number": "270-326-6116",
"fax_number": "270-326-6118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORDAL",
"first_name": "ROGER",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-27",
"last_updated": "2007-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KY",
"license": "SA026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madisonville, KY
- Joshua Odom, PHARMD
- Ohearn Medical, PLLC
- Ohio Valley Neurology LLC
- Heather Pendergraff Oldham, PHARMD
- Omni Visions, Inc
- Mark Allan Owen, PT
- Owensboro Health Medical Group, Inc (Owensboro Health Madisonville Healthplex)
- Owensboro Health Medical Group, Inc (Owensboro Health Medical Group - Physical Therapy)
- Owensboro Health Medical Group, Inc. (Owensboro Health Medical Group - Cardiology)
- Owensboro Health Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.