Roger L Siddoway, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

19338 Issued in AZ

Practice address

368 E Riverside Dr
Suite a
St George, UT 84790-6896

Phone

(435) 673-1149

Fax

(435) 673-1182

NPI assigned

Jan 18, 2006

Last updated

Jun 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Utah Gastroenterology LLC

  • Gastroenterology Physician
  • Salt Lake City, UT
  • NPI 1871689562
  Medicare reassignment NPD
• Utah Gastroenterology

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1124837646
  NPD

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1548240310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E",
            "address_2": "#220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 E RIVERSIDE DR",
            "address_2": "SUITE A",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847906896",
            "telephone_number": "435-673-1149",
            "fax_number": "435-673-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDOWAY",
        "first_name": "ROGER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "19338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170936",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaelyn James Ajaki Shumway
• Tyler Earl Shumway, DPT
• Bret Allen Shupe, DPT
• Joseph Siatini
• Sheila Siddall
• Amber Sidwell
• Randie Jo Sidwell
• Sienas Pharmacy LLC
• Bailey Sieverts
• Clarissa Sifford

• Gastroenterology Physician in St George, UT
• Providers in St George, UT by specialty
• Gastroenterology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.