ROGER D ANNIS (NPI# 1952350480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952350480 |
| Entity Type | Individual |
| Full Name | ROGER D ANNIS |
| Credential | MD |
| Practice Address |
4378 W Holt Rd Holt MI 48842-1666 |
| Practice Telephone | 5176941466 |
| Practice Fax Number | 5176943530 |
| Mailing Telephone | 5176941466 |
| Mailing Fax Number | 5176943530 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | RA048224 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 102805449 | 05 | |
| MI | PHYSICIANS HEALTH PLAN OF | 0100237 | 01 |
| BCBSM | RA048224 | 01 | |
| BCN BLUE CARE NETWORK | RA048224 | 01 | |
| MI | 0170237 | 05 |
| Street Address |
4378 W HOLT RD |
| City | HOLT |
| State | MI |
| Zip Code | 48842-1666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548219389 | Mark M Richardson | Family Medicine | 4378 W Holt Rd, Holt, MI 48842-1666 | 2006-05-09 |
| 1417991134 | Stephen G Tepastte | Family Medicine | 4378 W Holt Rd, Holt, MI 48842-1666 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730708538 | Dylan Voris | Psychologist | 4523 E Willoughby Rd., Holt, MI 48842 | 2020-04-11 |
| 1013458835 | Allison Ann Pingston | Specialist/Technologist | 23747 Rolling Ridge Ln., Holt, MI 48842 | 2017-03-13 |
| 1528417706 | Marybeth Timotiwu | Technician, Other | 3940 Acorn Cir, Holt, MI 48842 | 2016-06-08 |
| 1831593623 | Mary Nelson | Rehabilitation Practitioner | 3860 Wachtel Drive, Holt, MI 48842 | 2014-10-22 |
| 1598869703 | Nicole Elizabeth Durnin | Pharmacist | 2018 N. Cedar Street, Suite A, Holt, MI 48842 | 2006-09-08 |
| 1225130560 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2240 Cedar St, Holt, MI 48842 | 2006-09-05 |
| 1073622973 | Marilyn Viera | Family Medicine | 2380 Cedat St, Holt, MI 48842 | 2006-08-30 |
| 1942228291 | Stephen N. Glover | Pharmacist | 2390 N. Cedar St., Holt, MI 48842 | 2006-07-17 |
| 1740244169 | Pamela Thompson | Family Medicine | 4221 Charlar Dr, Holt, MI 48842 | 2006-04-13 |
| 1407847387 | Amy Lynn Cousineau | Optometrist | 2040 Aurelius Rd Ste 20, Holt, MI 48842 | 2005-10-31 |
| Find all providers in zip 48842 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238966 | Med Clubs | Family Medicine | 2575 Hummingbird Dr, Holt, MI 48842-9430 | 2020-08-31 |
| 1447582887 | Bio-care Inc | Family Medicine | 1778 Holloway Dr, Suite A, Holt, MI 48842-7725 | 2010-02-10 |
| 1831290402 | Jill L Stephenson-mccole | Family Medicine | 2040 Aurelius Rd, Holt, MI 48842-1367 | 2006-09-26 |
| 1073622973 | Marilyn Viera | Family Medicine | 2380 Cedat St, Holt, MI 48842 | 2006-08-30 |
| 1265479554 | Louis Lessard | Family Medicine | 4738 W Holt Rd, Holt, MI 48842-1666 | 2006-06-02 |
| 1356398655 | Dr. Linda Fisher-williams, D.o. | Family Medicine | 4801 Willoughby Rd, Holt, MI 48842-1000 | 2006-05-30 |
| 1548219389 | Mark M Richardson | Family Medicine | 4378 W Holt Rd, Holt, MI 48842-1666 | 2006-05-09 |
| 1407814916 | Timothy T Wellemeyer | Family Medicine | 4378 Holt Rd, Holt, MI 48842-1666 | 2006-05-03 |
| 1740244169 | Pamela Thompson | Family Medicine | 4221 Charlar Dr, Holt, MI 48842 | 2006-04-13 |
| 1891763306 | Renu Chaturvedi | Family Medicine | 2450 Delhi Commerce Dr, Suite 4, Holt, MI 48842-2193 | 2006-03-09 |
| Find all providers in HOLT | ||||
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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.