Individual provider Active NPI

Ted W Rogers, DC

  • Chiropractor
  • Windham, ME
National Provider Identifier
1023109204
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR584 Issued in ME
Practice address
744 Roosevelt Trail
Windham Crossing Suite 205
Windham, ME 04062
Phone
(207) 892-5430
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X CRA1195 ME
Chiropractor 111N00000X CR584 ME Primary

Addresses

Primary practice location

744 Roosevelt Trail
Windham Crossing Suite 205
Windham, ME 04062

Mailing address

744 Roosevelt Trail
Windham Crossing Suite 205
Windham, ME 04062
Phone (207) 892-5430

Other identifiers 1

IdentifierTypeStateIssuer
229360000MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118001136 ME Practitioner - Chiropractic 8224224027 Practice locations: Greenville, ME; Windham, ME

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

744 Roosevelt TRL
Suite 205
Windham, ME 04062-5281
Phone (207) 892-5430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR584MEMDChiropractor
CRA1195MEMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1023109204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 ROOSEVELT TRAIL",
            "address_2": "WINDHAM CROSSING SUITE 205",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "04062",
            "telephone_number": "207-892-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 ROOSEVELT TRAIL",
            "address_2": "WINDHAM CROSSING SUITE 205",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "04062",
            "telephone_number": "207-892-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TED",
        "middle_name": "W",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ME",
            "license": "CRA1195",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229360000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.