Individual provider Active NPI

Roger W Coomer, MD

  • Nephrology Physician
  • Huntsville, AL
National Provider Identifier
1720050990
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
00020499 Issued in AL
Practice address
2780 Bob Wallace Avenue
Suite E
Huntsville, AL 35805-4104
Phone
(256) 533-4626
Fax
(256) 533-4710
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 00020499 AL Primary

Addresses

Primary practice location

2780 Bob Wallace Avenue
Suite E
Huntsville, AL 35805-4104

Mailing address

2780 Bob Wallace Avenue
Huntsville, AL 35805-4104
Phone (256) 539-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080806000339 TN Practitioner - NephrologyPractitioner - Internal Medicine 9436223617 Reassigns benefits to 1 organization
I20100720000179 AL Practitioner - NephrologyPractitioner - Internal Medicine 9436223617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Vanderbilt University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Alabama Vascular and Dialysis Access Care LLCGroup PAC ID 5092121004, 4 clinicians
Nephrology Consultants LLCGroup PAC ID 5092603472, 17 clinicians

Practice addresses (Care Compare)

1311 Memorial Pkwy NW
Suite 300
Huntsville, AL 35801-5944
Phone (256) 535-5008

2780 Bob Wallace Ave
Hunstville, AL 35805-4104
Phone (256) 533-4626

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00020499ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Alabama Vascular and Dialysis Access Care LLC Nephrology CurrentSince Mar 1, 2021 Accepting new patients

Locations

1311 Memorial Pkwy NW
Ste 300
Huntsville, AL 35801
Phone (256) 535-5008

Interoperability endpoints

  • Direct secure messaging: roger.coomer.p138@direct.lifelinevascular.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1720050990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVENUE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-539-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVENUE",
            "address_2": "SUITE E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMER",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "00020499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.