DR. RANDOLPH W. ROLLER (NPI# 1386744068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386744068 |
| Entity Type | Individual |
| Full Name | DR. RANDOLPH W. ROLLER |
| Credential | M.D. |
| Practice Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2008-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
036-054648 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360546648 | 05 |
| Street Address |
1025 S 6TH ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62703-2403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346244241 | Christopher A Sprinkel | Physician Assistant | 1025 S 6th St, Springfield, IL 62703-2403 | 2005-06-08 |
| 1629682596 | Mackenzie Marie Bowers | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-09-08 |
| 1164031803 | Erica J Carr | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-07-29 |
| 1770104960 | Ashlee D. Schoby | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-04-29 |
| 1245869197 | Megan M Ferrill | Physician Assistant | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-04-03 |
| 1649805706 | Sarah E. Treat | Physician Assistant | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-03-10 |
| 1538708086 | Ellen Michelle Clark | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2020-01-02 |
| 1730724386 | Hannah R Burdell | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2019-11-07 |
| 1689218950 | Rachel L Puckett | Physician Assistant | 1025 S 6th St, Springfield, IL 62703-2403 | 2019-10-30 |
| 1982259479 | Kastin I Engeling | Nurse Practitioner | 1025 S 6th St, Springfield, IL 62703-2403 | 2019-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
| 1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
| 1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
| 1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
| 1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
| 1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
| Find all providers in zip 62703 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225135171 | Donald P Kratz | Obstetrics & Gynecology | 1135 E Lakewood St, Suite112, Springfield, MO 65810-2434 | 2006-09-20 |
| 1134142987 | Robert Allen Shearer | Obstetrics & Gynecology | 801 Hill St, Springfield, TN 37172-2951 | 2006-07-25 |
| 1629031448 | Howard G Trietsch | Obstetrics & Gynecology | 3455 Main St Ste C, Springfield, MA 01107-1187 | 2006-04-11 |
| 1861454092 | James Lynn Cromwell | Obstetrics & Gynecology | 2121 East High Street, Springfield, OH 45505-1368 | 2006-04-04 |
| 1649540592 | Dr James L Cromwell Md Inc | Obstetrics & Gynecology | 2121 E High St, Springfield, OH 45505-1368 | 2012-01-10 |
| 1821279928 | Dalila D. Harvey -granger | Obstetrics & Gynecology | 6501 Loisdale Ct, Kaiser Permanente Springfield Medical Center, Springfield, VA 22150-1826 | 2007-11-16 |
| 1285789651 | Marilyn Anne Hajar | Obstetrics & Gynecology | 3550 Main St, Suite 201, Springfield, MA 01107-1089 | 2007-01-24 |
| 1710073382 | Ernest E Ertmoed | Obstetrics & Gynecology | 900 N. 1st Street, Springfield, IL 62702-3749 | 2006-10-04 |
| 1841398401 | Woman's Clinic, Inc | Obstetrics & Gynecology | 1135 E Lakewood St, Suite112, Springfield, MO 65810-2434 | 2006-09-20 |
| 1285731141 | David L Redfern Jr. | Obstetrics & Gynecology | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2006-09-20 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.