Individual provider Active NPI

Larry Calvin Rogers, M.D.

  • Family Medicine Physician
  • Petersburg, WV
National Provider Identifier
1043395668
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10484 Issued in WV
Practice address
7 Memorial Drive
Petersburg, WV 26847-0007
Phone
(304) 257-4511
Fax
(304) 257-4511
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10484 WV Primary

Addresses

Primary practice location

7 Memorial Drive
Petersburg, WV 26847-0007

Mailing address

PO Box 7
Petersburg, WV 26847-0007
Phone (304) 257-4511

Other identifiers 1

IdentifierTypeStateIssuer
0055759000MedicaidWV

Other names 1

  • Mrs. Alta Faye Rogers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043395668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268470007",
            "telephone_number": "304-257-4511",
            "fax_number": "304-257-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MEMORIAL DRIVE",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268470007",
            "telephone_number": "304-257-4511",
            "fax_number": "304-257-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LARRY",
        "middle_name": "CALVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "10484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055759000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALTA",
            "last_name": "ROGERS",
            "middle_name": "FAYE",
            "prefix": "MRS.",
            "credential": "R.N.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.