NPIMap

Organization Active NPI

Roller Weight Loss Institute Inc

  • Surgery Physician
  • Tulsa, OK
National Provider Identifier
1912446741
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E5193 Issued in AR
Legal business name
ROLLER WEIGHT LOSS INSTITUTE INC
Practice address
8005 E 106TH St
Tulsa, OK 74133-6600
Phone
(918) 970-6366
Fax
(479) 445-6719
NPI assigned
Feb 13, 2017
Last updated
Aug 3, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ROLLER WEIGHT LOSS INSTITUTE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
Dr. Joshua Roller, MDNPI 1790713675
Title
Ceo/President
Phone
(479) 445-6460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E5193 AR Primary

Addresses

Primary practice location

8005 E 106TH St
Tulsa, OK 74133-6600

Mailing address

1695 E Rainforest Rd
Fayetteville, AR 72703-5385
Phone (479) 445-6460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170809001504 OK Part B Supplier - Clinic/Group Practice 0446398770 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Roller WGHT LSS Inst Inc

Locations

1280 E Stearns St
Ste 5
Fayetteville, AR 72703
Phone (479) 445-6460

1695 E Rainforest Rd
Fayetteville, AR 72703
Phone (479) 445-6460

3311 E 46th St
#A
Tulsa, OK 74135
Phone (877) 445-6460

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1912446741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 E RAINFOREST RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035385",
            "telephone_number": "479-445-6460",
            "fax_number": "479-445-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8005 E 106TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336600",
            "telephone_number": "918-970-6366",
            "fax_number": "479-445-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLER WEIGHT LOSS INSTITUTE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROLLER WEIGHT LOSS INSTITUTE INC",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "ROLLER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "479-445-6460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E5193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.