Dr. Roger K Johnson , MD
Specialist • Rockford, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Roger Johnson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Roger Johnson, MD was a registered Specialist practicing in Rockford, IL. Throughout an active medical career spanning 15 years, Dr. Johnson provided care at the practice location at 351 EXECUTIVE PKWY STE M1 until profile deactivation on 2021-01-20.
Practice Location & Contact Primary Location
351 Executive Pkwy Ste M1
Rockford, IL 611075298
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Rockford, IL
Practicing in Rockford, IL (1322 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on January 20, 2021
NPI status registered as active in NPPES database
Registered at 351 EXECUTIVE PKWY STE M1, ROCKFORD, IL 611075298 (Tel: 8153958100)
Registered at 351 EXECUTIVE PKWY STE M1, ROCKFORD, IL 611075298 (Tel: 8153958100)
Recorded as ROGER JOHNSON, M.D.
Specialist
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
351 Executive Pkwy Ste M1
Rockford, IL 611075298
Phone: 8153958100
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