Active NPI
Rex Daniel Roach III, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Mobile, AL
National Provider Identifier
1922468677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 21974
- Practice address
- 6554 Lubarrett Way
Mobile, AL 36695-3825 - Phone
- (251) 533-3221
- NPI assigned
- Feb 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 21974 | AL | Primary |
Addresses
Primary practice location
6554 Lubarrett Way
Mobile, AL 36695-3825
Mailing address
6554 Lubarrett Way
Mobile, AL 36695-3825
Phone (251) 533-3221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21974 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456185600000",
"number": "1922468677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6554 LUBARRETT WAY",
"city": "MOBILE",
"state": "AL",
"postal_code": "366953825",
"telephone_number": "251-533-3221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6554 LUBARRETT WAY",
"city": "MOBILE",
"state": "AL",
"postal_code": "366953825",
"telephone_number": "251-533-3221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "REX",
"middle_name": "DANIEL",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-23",
"last_updated": "2016-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AL",
"license": "21974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.