NPIMap

Individual provider Active NPI

Roger D Anderson, MD

  • Infectious Disease Physician
  • Marietta, OH
National Provider Identifier
1689676264
Registry record updated Sep 5, 2012
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective May 19, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
35.063586 Issued in OH
Practice address
101 Putnam St
Marietta, OH 45750-2924
Phone
(740) 374-9990
Fax
(740) 374-9993
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35063586 OH
Infectious Disease Physician 207RI0200X 35.063586 OH Primary
Internal Medicine Physician 207R00000X 35.063586 OH

Addresses

Primary practice location

101 Putnam St
Marietta, OH 45750-2924

Mailing address

PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500

Other identifiers 4

IdentifierTypeStateIssuer
0077532001MedicaidWV
000000391651OtherOHANTHEM
2276880MedicaidOH
P00338056OtherOHRRMCR

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35063586OHMDEmergency Medicine Physician
35.063586OHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
4M Emergency Systems of West Virginia Emergency Medicine Past Accepting new patients
Marietta Ambulance Service LTD PastSince Feb 9, 2011 Accepting new patients
Anderson Medical Group PastSince Nov 1, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
4M Emergency Systems of Parkersburg, Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1689676264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PUTNAM ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457502924",
            "telephone_number": "740-374-9990",
            "fax_number": "740-374-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROGER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35063586",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35.063586",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.063586",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077532001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000391651",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2276880",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00338056",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.