Cedric Michael Rogers, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4735 Issued in SC

Practice address

210 Village Center Blvd
Myrtle Beach, SC 29579-6706

Phone

(843) 353-3460

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1073235636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HINSON DR APT 136",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794443",
            "telephone_number": "910-674-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CEDRIC",
        "middle_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Euleidys Michelle Rodriguez Rosario
• Jonathan Rodriguez, DO
• Joseph Rodriguez, DMD
• Woodrow Anthony Roeback III, CPC, CRC, LPC
• Rogers Chiropractic LLC
• Kenneth Alexander Rogers, D.C.
• Lindsey Amanda Rogers
• Shata Rogers
• Susan Rogers, CCC-SLP
• William Jordan Rogers, DC

• Physical Therapy Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.