Active NPI
Ryan Willard Rogers, PA-C
- Physician Assistant
- Osage Beach, MO
National Provider Identifier
1124325907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2011003943
- Practice address
- 1029 Nichols Rd Ste 201
Osage Beach, MO 65065-3008 - Phone
- (573) 302-7138
- NPI assigned
- Feb 14, 2011
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2011003943 | MO | Primary |
Addresses
Primary practice location
1029 Nichols Rd Ste 201
Osage Beach, MO 65065-3008
Mailing address
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000
Other practice location 1
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other practice location 2
755 Cowan Dr
Lebanon, MO 65536-4629
Phone (417) 532-2508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220026034 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3990
54 Hospital Dr
Osage Beach, MO 65065-3050
Hospital & facility affiliations
- Lake Regional Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Physician Assistant | Current | Accepting new patients |
| Lake Regional Health System | Past | Accepting new patients |
Interoperability endpoints
- rrogers@mhccaremail.com
- lakeregionalgastroenterology@mhccaremail.com
- rrogers125359@directb.mercy.net
Organizations & group practices 5
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Osage Beach, MO
- NPI 1053581454
-
- Emergency Medicine Physician
- Osage Beach, MO
- NPI 1003181637
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Rural Health Clinic/Center
- Mountain View, MO
- NPI 1003946732
Physician Assistant
-
- Internal Medicine Physician
- Osage Beach, MO
- NPI 1962828616
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Osage Beach, MO
- NPI 1386619450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1124325907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 HOSPITAL DR",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653050",
"telephone_number": "573-348-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 NICHOLS RD STE 201",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653008",
"telephone_number": "573-302-7138"
}
],
"practiceLocations": [
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-458-8899",
"fax_number": "573-341-5611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "755 Cowan Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "MO",
"postal_code": "655364629",
"country_code": "US",
"telephone_number": "417-532-2508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROGERS",
"first_name": "RYAN",
"middle_name": "WILLARD",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-14",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2011003943",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220026034",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.