Active NPI
Robert Roark, CHA
- Pediatrics Physician
- Aurora, CO
National Provider Identifier
1760566491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 358
- Practice address
- 13123 E 16TH Ave
Aurora, CO 80045-7106 - Phone
- (720) 777-1234
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 358 | CO | Primary |
Addresses
Primary practice location
13123 E 16TH Ave
Aurora, CO 80045-7106
Mailing address
13611 E Colfax Ave
Aurora, CO 80045-5701
Phone (303) 493-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07107121 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1760566491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13611 E COLFAX AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800455701",
"telephone_number": "303-493-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROARK",
"first_name": "ROBERT",
"credential": "CHA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "358",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07107121",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.