MEDICARE: JAMES ROAT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	23838	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	20520	OTHER	NE	NEBRASKA BLUE SHIELD
3	A002980	OTHER		TRICARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457331621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROAT M.D.

Provider Business Mailing Address
First Line	:	2910 HAMILTON BLVD
Second Line	:	STE 103
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-2423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2910 HAMILTON BLVD
Second Line	:	STE 103
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-2423
Country	:	US
Telephone Number	:	712-252-1322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2006
Last Update Date	:	07/08/2007

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