Logan Roles

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5576 Issued in OK

Practice address

9800 Broadway Ext Ste 203
Oklahoma City, OK 73114-6304

Phone

(405) 424-5426

NPI assigned

Mar 10, 2025

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

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lroles530876@direct-ehr-ssmhc.com

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.

• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297

  Physician Assistant

  Medicare reassignment NPD
• The Physicians Group LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1487620381
  Medicare reassignment
• St Anthony Shawnee Hospital Inc

  dba St Anthony Shawnee Hospital

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  NPD (past)

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

• St Anthony Shawnee Hospital Inc

  dba St Anthony Shawnee Hospital

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  Care Compare affiliation

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1720887169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 BROADWAY EXT STE 203",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146304",
            "telephone_number": "405-424-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 BROADWAY EXT STE 203",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146304",
            "telephone_number": "405-424-5426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 W MacArthur St",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748041743",
            "country_code": "US",
            "telephone_number": "405-273-2270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLES",
        "first_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-10",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Roland
• Chanel Roland
• Irving Roland
• Kelli P Roland
• Lee Roland
• Dorothy J. Rolfe
• Mark W Rolfe, MD
• Taylor Rolfs
• Astanzia Rolin
• Mary Rose Rolison, PH.D.

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.
• 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.