Individual provider Active NPI

Charles D Rogers, D.O.

  • Family Medicine Physician
  • Muskogee, OK
National Provider Identifier
1134216575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2896 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(918) 683-3261
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2896 OK Primary

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone (918) 683-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000113 OK Practitioner - Family Practice 9234317199 Practice locations: Muskogee, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2896OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St John Medical Center Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134216575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-683-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-683-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.