NPIMap

Organization Active NPI

Roger H. Tall M.D. P.a.

  • Specialist
  • Idaho Falls, ID
National Provider Identifier
1912238544
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
M4222 Issued in ID
Legal business name
ROGER H. TALL M.D. P.A.
Practice address
2001 S Woodruff
Suite 8
Idaho Falls, ID 83404
Phone
(208) 529-0633
Fax
(208) 529-1948
NPI assigned
Jan 21, 2010
Last updated
Mar 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Authorized official

Name
Dr. Roger H Tall, M.D.NPI 1972604494
Title
President
Phone
(208) 529-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X M4222 ID Primary

Addresses

Primary practice location

2001 S Woodruff
Suite 8
Idaho Falls, ID 83404

Mailing address

2001 S Woodruff
Suite 8
Idaho Falls, ID 83404
Phone (208) 529-0633

National Provider Directory

National Provider Directory

Locations

2001 S Woodruff Ave
Ste 8
Idaho Falls, ID 83404
Phone (208) 529-0633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1912238544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF",
            "address_2": "SUITE 8",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-0633",
            "fax_number": "208-529-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF",
            "address_2": "SUITE 8",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-0633",
            "fax_number": "208-529-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER H. TALL M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "TALL",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-529-0633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M4222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.