Individual provider Active NPI

Daniel M O'Roark, DO

  • Cardiovascular Disease Physician
  • Johnson City, TN
National Provider Identifier
1740216910
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
1720 Issued in TN
Practice address
701 N State of Franklin Rd
Ste 9
Johnson City, TN 37604-3645
Phone
(423) 926-4468
Fax
(423) 928-4838
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1720 TN
Cardiovascular Disease Physician 207RC0000X 0102201788 VA
Cardiovascular Disease Physician 207RC0000X OS006046E PA
Cardiovascular Disease Physician 207RC0000X 1720 TN Primary

Addresses

Primary practice location

701 N State of Franklin Rd
Ste 9
Johnson City, TN 37604-3645

Mailing address

701 N State of Franklin Rd
Ste 2
Johnson City, TN 37604-3645
Phone (423) 926-4468

Other identifiers 4

IdentifierTypeStateIssuer
64108509MedicaidKY
1740216910MedicaidVA
3319525MedicaidTN
621112685OtherTNUNITED HEALTHCARE

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2022 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1720TNMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
All County Cardiology, P.C. Cardiovascular Disease Past Accepting new patients
Karing Hearts Cardiology PC Cardiovascular Disease Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1740216910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD",
            "address_2": "STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-926-4468",
            "fax_number": "423-928-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD",
            "address_2": "STE 9",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-926-4468",
            "fax_number": "423-928-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROARK",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "1720",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0102201788",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS006046E",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "1720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64108509",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740216910",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3319525",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "621112685",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.