John D Roll, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

24114 Issued in OR

Practice address

9205 SW Barnes Rd
Portland, OR 97225-6603

Phone

(503) 216-4830

Fax

(503) 216-4850

NPI assigned

Jan 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Medical Imaging Group, LLC

  • Radiology Clinic/Center
  • Tigard, OR
  • NPI 1043456643
  NPD (past)
• Tanasbourne Radiology

  • Specialist
  • Aloha, OR
  • NPI 1649242819
  NPD (past)
• The Radiology Group, P.C.

  • Specialist
  • Newberg, OR
  • NPI 1942253687
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1891766911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 SW BARNES RD",
            "address_2": "SUITE 307",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256608",
            "telephone_number": "503-292-9108",
            "fax_number": "503-292-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-4830",
            "fax_number": "503-216-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "24114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286240",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Roland, O.D.
• Tarasa Roland, CSWA
• Sierra Roles, RN
• Rolfing Portland Oregon, LLC
• Alexander Joseph Roll
• Todd Alexander Roll
• Steven Brent Rolland, LMT
• Matthew Kai Roller, LCSW
• Amber Leigh Rollins
• Christopher R Rollins, CSWA, LSWAIC

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.