Richard A Roque, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

5503 Marvin Shields Blvd
Sea Bee Base Clinic
Gulfport, MS 39501

Phone

(228) 871-2810

NPI assigned

May 22, 2007

Last updated

Apr 20, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1760691810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "NMCB 7 MEDICAL DEPARTMENT",
            "address_2": "UNIT 60252",
            "city": "FPO",
            "state": "AA",
            "postal_code": "34099",
            "telephone_number": "228-223-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 MARVIN SHIELDS BLVD",
            "address_2": "SEA BEE BASE CLINIC",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-871-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Roland, LCSW
• Connie R. Rolison, W.H.N.P.
• Alison Rollinson
• Mary Jane Romero
• Stephanie D Romero, CFNP
• James Lawrence Rose II, MD
• Cynthia Rosenberry, CRNA
• Tanya Rosenzweig
• Aaron Rayne Rosetti, FNP-BC
• Jason Oser Rosetti, DDS

• Independent Duty Corpsman in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Independent Duty Corpsman in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.