Active NPI
Benjamin L Rodgers, MD
- Pediatrics Physician
- Summerville, SC
National Provider Identifier
1104811983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20260
- Practice address
- 748 Orangeburg Rd
Summerville, SC 29483-8934 - Phone
- (843) 832-8606
- Fax
- (843) 285-7272
- NPI assigned
- Sep 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20260 | SC | Primary |
Addresses
Primary practice location
748 Orangeburg Rd
Summerville, SC 29483-8934
Mailing address
748 Orangeburg Rd
Summerville, SC 29483-8934
Phone (843) 832-8606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T43441 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20260 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sweetgrass Pediatrics | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- North Charleston, SC
- NPI 1437168135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1104811983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "748 ORANGEBURG RD",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294838934",
"telephone_number": "843-832-8606",
"fax_number": "843-285-7272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "748 ORANGEBURG RD",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294838934",
"telephone_number": "843-832-8606",
"fax_number": "843-285-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "BENJAMIN",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-16",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "20260",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "T43441",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.