Organization Active NPI

Stuart D Rogers, OD

  • Eyewear Supplier
  • Henderson, TN
National Provider Identifier
1063690733
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
ODT857 Issued in TN
Legal business name
STUART D ROGERS, OD
Practice address
124 N Washington Ave
Henderson, TN 38340-1800
Phone
(731) 989-2711
Fax
(731) 989-2778
NPI assigned
Feb 5, 2008
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Stuart D Rogers, O.D.NPI 1811959265
Title
Owner
Phone
(731) 989-2711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X ODT857 TN Primary

Addresses

Primary practice location

124 N Washington Ave
Henderson, TN 38340-1800

Mailing address

PO Box 159
Henderson, TN 38340-0159
Phone (731) 989-2711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930044713 TN DME Supplier - Physician - Optometrist 4981721826 Practice locations: Henderson, TN

National Provider Directory

National Provider Directory

Locations

124 N Washington Ave
Henderson, TN 38340
Phone (731) 989-2711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1063690733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383400159",
            "telephone_number": "731-989-2711",
            "fax_number": "731-989-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N WASHINGTON AVE",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383401800",
            "telephone_number": "731-989-2711",
            "fax_number": "731-989-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART D ROGERS, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-989-2711",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TN",
            "license": "ODT857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.