Organization Active NPI

Gastroenterology Assoc., LLP

  • Specialist
  • Abilene, TX
National Provider Identifier
1508846049
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GASTROENTEROLOGY ASSOC., LLP
Practice address
1249 Ambler Ave
Suite 200
Abilene, TX 79601-2351
Phone
(325) 677-2626
Fax
(325) 677-6835
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Dr. Gary D Roark, M.D.NPI 1003896531
Title
Physician
Phone
(325) 677-2626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X TX Primary

Addresses

Primary practice location

1249 Ambler Ave
Suite 200
Abilene, TX 79601-2351

Mailing address

1249 Ambler Ave
Suite 200
Abilene, TX 79601-2351
Phone (325) 677-2626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080321000180 TX Part B Supplier - Clinic/Group Practice 1254417918 Receives reassigned benefits from 7 practitioners
Practice locations: Abilene, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0865710Gastroenterology Associates of Abilene1249 Ambler Suite 200, Abilene, TX 79601Certificate of waiverAug 31, 2026
45D2339323Gastroenterology Associates of Abilene, LLP1249 Ambler Avenue Suite 200, Abilene, TX 79601RegistrationFeb 26, 2028

National Provider Directory

National Provider Directory

Locations

1249 Ambler Ave
Ste 200
Abilene, TX 79601
Phone (325) 677-2626

1249 Ambler Ave
Abilene, TX 79601
Phone (325) 677-2626

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1508846049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 AMBLER AVE",
            "address_2": "SUITE 200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012351",
            "telephone_number": "325-677-2626",
            "fax_number": "325-677-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 AMBLER AVE",
            "address_2": "SUITE 200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012351",
            "telephone_number": "325-677-2626",
            "fax_number": "325-677-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOC., LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "325-677-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.