Active NPI
Rogers King Coleman, M.D.
- General Practice Physician
- Granbury, TX
National Provider Identifier
1407261233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- C5636
- Practice address
- 1411 Crawford Street
Granbury, TX 76048 - Phone
- (817) 573-6800
- Fax
- (817) 573-6802
- NPI assigned
- Jul 1, 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | C5636 | TX | Primary |
Addresses
Primary practice location
1411 Crawford Street
Granbury, TX 76048
Mailing address
1411 Crawford Street
Granbury, TX 76048
Phone (817) 573-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C6536 | Other | TX | TEXAS 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 |
|---|---|---|---|
| C5636 | TX | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1407261233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 CRAWFORD STREET",
"city": "GRANBURY",
"state": "TX",
"postal_code": "76048",
"telephone_number": "817-573-6800",
"fax_number": "817-573-6802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 CRAWFORD STREET",
"city": "GRANBURY",
"state": "TX",
"postal_code": "76048",
"telephone_number": "817-573-6800",
"fax_number": "817-573-6802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "ROGERS",
"middle_name": "KING",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-01",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "TX",
"license": "C5636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS LICENSE",
"identifier": "C6536",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.