Active NPI
Mark Edward Rogers, PHARM.D.
- Pharmacist
- New London, CT
National Provider Identifier
1114167384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0011060
- Practice address
- 365 Montauk Ave
New London, CT 06320-4769 - Phone
- (860) 271-4914
- Fax
- (860) 444-4759
- NPI assigned
- Mar 2, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH04760 | RI | |
| Pharmacist | 183500000X | PCT.0011060 | CT | Primary |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4769
Mailing address
365 Montauk Ave
New London, CT 06320-4769
Phone (890) 271-4914
Other practice location 1
25 Wells St
Westerly, RI 02891-2934
Phone (401) 348-3349
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0011060 | CT | MD | Pharmacist |
| RPH04760 | RI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1114167384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204769",
"telephone_number": "890-271-4914",
"fax_number": "860-444-4759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204769",
"telephone_number": "860-271-4914",
"fax_number": "860-444-4759"
}
],
"practiceLocations": [
{
"address_1": "25 Wells St",
"address_purpose": "LOCATION",
"city": "Westerly",
"state": "RI",
"postal_code": "028912934",
"country_code": "US",
"telephone_number": "401-348-3349",
"fax_number": "401-348-3598",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROGERS",
"first_name": "MARK",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-02",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH04760",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0011060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.