Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1760584734 Deactivated / Inactive NPI Male Practitioner

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.

Registration / Start Date September 01, 2006
NPI Deactivation Date January 20, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

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

Practice Address

351 Executive Pkwy Ste M1

Rockford, IL 611075298

Telephone 8153958100
Fax 8153958179

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Rockford, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 38.5 Yrs
Regional Practice Density
26 Specialists

Practicing in Rockford, IL (1322 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

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

7 Historical Events
⚠️
NPI Profile Deactivated January 20, 2021

Record deactivated on January 20, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 351 EXECUTIVE PKWY STE M1, ROCKFORD, IL 611075298 (Tel: 8153958100)

📍
Updated Business Mailing Address July 08, 2007

Registered at 351 EXECUTIVE PKWY STE M1, ROCKFORD, IL 611075298 (Tel: 8153958100)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as ROGER JOHNSON, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist

🟢
Initial NPI Registration & Enumeration September 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Roger Johnson. Be the first to share your experience!

Sign in to leave a review for Dr. Roger Johnson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1760584734
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 01, 2006
Last Update: July 08, 2007
Deactivation Date: January 20, 2021

Mailing Address

351 Executive Pkwy Ste M1

Rockford, IL 611075298

Phone: 8153958100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.