Individual provider Active NPI

John C Root, MD

  • Family Medicine Physician
  • Rockport, TX
National Provider Identifier
1871589341
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P1136 Issued in TX
Practice address
1202 FM 3036
Rockport, TX 78382-7798
Phone
(361) 729-0133
Fax
(361) 729-0855
NPI assigned
Sep 21, 2005
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P1136 TX Primary
Family Medicine Physician 207Q00000X 20046 OK

Addresses

Primary practice location

1202 FM 3036
Rockport, TX 78382-7798

Mailing address

1202 FM 3036
Rockport, TX 78382-7798
Phone (361) 729-0133

Other identifiers 5

IdentifierTypeStateIssuer
080115102OtherRAILROAD MEDICARE
100126830BMedicaidOK
347459101OtherOKDOL
5008436OtherOKAETNA
100126830AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220718003064 TX Practitioner - Family Practice 6204909435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Un of British Columbia, Faculty of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

1202 FM
Suite 3036
Rockport, TX 78382-7798
Phone (361) 729-0133

2922 Morgan Ave
Corpus Christi, TX 78405-2141
Phone (361) 887-6601

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20046OKMDFamily Medicine Physician
P1136TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Wellmed Medical Group, PA Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients

Locations

1202 FM 3036
Rockport, TX 78382
Phone (361) 729-0133

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: john.root@wellmed.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
JCMH Women's Health AssociatesAltus, OK, CCN 373483 Rural health clinic Corporate Director Nov 19, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1871589341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 FM 3036",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783827798",
            "telephone_number": "361-729-0133",
            "fax_number": "361-729-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 FM 3036",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783827798",
            "telephone_number": "361-729-0133",
            "fax_number": "361-729-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1136",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "20046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080115102",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100126830B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "347459101",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5008436",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100126830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, TX

Sources for this page

Verify at the official NPI Registry.