Active NPI
William Randolph Rogers, D.O.
- Adult Medicine Physician
- San Marcos, TX
National Provider Identifier
1619041415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- E5912
- Practice address
- 310 Stagecoach TRL
Suite 200
San Marcos, TX 78666-5134 - Phone
- (512) 396-4700
- Fax
- (512) 396-4796
- NPI assigned
- Nov 20, 2006
- 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 |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | E5912 | TX | Primary |
Addresses
Primary practice location
310 Stagecoach TRL
Suite 200
San Marcos, TX 78666-5134
Mailing address
134 E Sierra Cir
San Marcos, TX 78666-2534
Phone (512) 396-3963
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F0027239 | Other | TX | TX CONTROLLED SUBSTANCE |
| E5912 | Other | TX | MEDICAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1619041415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 E SIERRA CIR",
"city": "SAN MARCOS",
"state": "TX",
"postal_code": "786662534",
"telephone_number": "512-396-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 STAGECOACH TRL",
"address_2": "SUITE 200",
"city": "SAN MARCOS",
"state": "TX",
"postal_code": "786665134",
"telephone_number": "512-396-4700",
"fax_number": "512-396-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "WILLIAM",
"middle_name": "RANDOLPH",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "TX",
"license": "E5912",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX CONTROLLED SUBSTANCE",
"identifier": "F0027239",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "E5912",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.