Individual provider Active NPI

Roger Kirk Zacher, DDS

  • Dentist
  • Chesterfield, MO
National Provider Identifier
1841509767
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10681 Issued in MO
Practice address
383 Shetland Valley CT.
Chesterfield, MO 63005
Phone
(636) 536-1145
Fax
(636) 536-1145
NPI assigned
Sep 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10681 MO Primary

Addresses

Primary practice location

383 Shetland Valley CT.
Chesterfield, MO 63005

Mailing address

383 Shetland Valley CT.
Chesterfield, MO 63005
Phone (636) 536-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160114000456 MO Order and Referring Only - DentistPractitioner - Dentist 0446553036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10681MOMDDentist

Interoperability endpoints

  • Direct secure messaging: roger.zacher.p1@direct.affiniahealthcare.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1841509767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 SHETLAND VALLEY CT.",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-536-1145",
            "fax_number": "636-536-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 SHETLAND VALLEY CT.",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-536-1145",
            "fax_number": "636-536-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHER",
        "first_name": "ROGER",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "10681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.