Individual provider Active NPI

Roger Lee Harcourt, M.D.

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1831300532
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME95059 Issued in FL
Practice address
4430 14TH St W
Bradenton, FL 34207-1425
Phone
(941) 297-2123
Fax
(941) 297-2210
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X AJ002516L PA
Internal Medicine Physician 207R00000X MD072508L PA
Internal Medicine Physician 207R00000X ME95059 FL Primary
Orthopedic Chiropractor 111NX0800X DC-002516-L PA
Internal Medicine Physician 207R00000X 2008 00631 NC

Addresses

Primary practice location

4430 14TH St W
Bradenton, FL 34207-1425

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080320000396 FL Practitioner - Internal Medicine 3375629074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Medical of Florida LLCGroup PAC ID 5597127456, 15 clinicians

Practice addresses (Care Compare)

4430 14TH St W
Bradenton, FL 34207-1425
Phone (941) 297-2123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AJ002516LPAMDRehabilitation Chiropractor
DC-002516-LPAMDOrthopedic Chiropractor
2008 00631NCMDInternal Medicine Physician
MD072508LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Medical of Florida, LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Trinity Medical Physicians, LLC Internal Medicine CurrentSince May 23, 2022 Accepting new patients
Epn Family Care LLC Past Accepting new patients
Conviva Medical Center Management LLC Internal Medicine PastSince Apr 19, 2014 Accepting new patients
Epn Urgent Care LLC Past Accepting new patients
Emergency Physicians of Naples PLLC Past Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients
Metcare of Florida, Inc Internal Medicine Past Accepting new patients
Memorial Enterprises, Inc. Past Accepting new patients
Memorial Enterprises Inc Past Accepting new patients

Locations

4430 14th St W
Bradenton, FL 34207
Phone (941) 297-2123

3240 S Florida Ave
Ste 105
Lakeland, FL 33803
Phone (863) 644-7337

3240 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 644-7337

3240 S Florida Ave
Ste 100
Lakeland, FL 33803
Phone (863) 646-4000

425 W Colonial Dr
Ste 303
Orlando, FL 32804
Phone (321) 332-6947

6900 Tavistock Lakes Blvd
Ste 300
Orlando, FL 32827
Phone (321) 332-6947

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1831300532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071425",
            "telephone_number": "941-297-2123",
            "fax_number": "941-297-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARCOURT",
        "first_name": "ROGER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "AJ002516L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD072508L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95059",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "PA",
            "license": "DC-002516-L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008 00631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.