Active NPI
Glendon P Rougeou, MD
- Family Medicine Physician
- San Francisco, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 070764
- Practice address
- 1 California St Ste 2300
San Francisco, CA 94111-5424 - Phone
- (415) 504-3838
- Fax
- (415) 504-1367
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036159042 | IL | |
| Family Medicine Physician | 207Q00000X | MD61258786 | WA | |
| Family Medicine Physician | 207Q00000X | T6468 | TX | |
| Family Medicine Physician | 207Q00000X | MD-49368 | IA | |
| Family Medicine Physician | 207Q00000X | 65671 | AZ | |
| Family Medicine Physician | 207Q00000X | 070764 | GA | Primary |
| Family Medicine Physician | 207Q00000X | 52347 | KY | |
| Family Medicine Physician | 207Q00000X | 87337 | SC | |
| Family Medicine Physician | 207Q00000X | 329649 | LA | |
| Family Medicine Physician | 207Q00000X | ME138774 | FL | |
| Family Medicine Physician | 207Q00000X | 21854 | NV | |
| Family Medicine Physician | 207Q00000X | DR.0060480 | CO | |
| Family Medicine Physician | 207Q00000X | MD466294 | PA | |
| Family Medicine Physician | 207Q00000X | 62246 | CT | |
| Family Medicine Physician | 207Q00000X | 58719 | TN |
Addresses
Primary practice location
1 California St Ste 2300
San Francisco, CA 94111-5424
Mailing address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (415) 504-3838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5907241 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Louisiana State University School of Medicine in Shreveport, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1404 Willow LN
Suite a
North Wilkesboro, NC 28659-3584
Phone (336) 667-4178
Hospital & facility affiliations
- North Carolina Baptist Hospital
- Lexington Memorial Hospital Inc
- Novant Health Thomasville Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65671 | AZ | MD | Family Medicine Physician |
| DR.0060480 | CO | MD | Family Medicine Physician |
| 62246 | CT | MD | Family Medicine Physician |
| ME138774 | FL | MD | Family Medicine Physician |
| MD-49368 | IA | MD | Family Medicine Physician |
| 036159042 | IL | MD | Family Medicine Physician |
| 52347 | KY | MD | Family Medicine Physician |
| 329649 | LA | MD | Family Medicine Physician |
| 21854 | NV | MD | Family Medicine Physician |
| MD466294 | PA | MD | Family Medicine Physician |
| 87337 | SC | MD | Family Medicine Physician |
| 58719 | TN | MD | Family Medicine Physician |
| T6468 | TX | MD | Family Medicine Physician |
| MD61258786 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients | |
| Urgent Care Clinic of Lincoln, P.C. | Past | Accepting new patients |
Locations
3150 N Elm St
Greensboro, NC 27408
Phone (336) 716-7811
1534 W D St
North Wilkesboro, NC 28659
Phone (336) 667-4178
1404 Willow Ln
Ste A
North Wilkesboro, NC 28659
Phone (336) 667-4178
711 National Hwy
Ste 100
Thomasville, NC 27360
Phone (336) 475-2000
1930 N Peace Haven Rd
Winston Salem, NC 27106
Phone (336) 760-5400
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- grougeou2754268@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Urgent Care Clinic/Center
- Lincoln, NE
- NPI 1962408732
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lexington, NC
- NPI 1417958331
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
-
- General Acute Care Hospital
- Thomasville, NC
- NPI 1801848767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1992719371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CALIFORNIA ST STE 2300",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941115424",
"telephone_number": "415-504-3838",
"fax_number": "415-504-1367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CALIFORNIA ST STE 2300",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941115424",
"telephone_number": "415-504-3838",
"fax_number": "415-504-1367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUGEOU",
"first_name": "GLENDON",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036159042",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61258786",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "T6468",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "MD-49368",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "65671",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "070764",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "52347",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "87337",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "329649",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME138774",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "21854",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "DR.0060480",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD466294",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "62246",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "58719",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5907241",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.