Active NPI
Kathleen S Rogers, MD
- Pediatrics Physician
- Missoula, MT
National Provider Identifier
1235179508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5347
- Practice address
- 2835 Fort Missoula Road
Missoula, MT 59804-7408 - Phone
- (406) 721-5600
- Fax
- (406) 721-3907
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- 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 | 5347 | MT | Primary |
Addresses
Primary practice location
2835 Fort Missoula Road
Missoula, MT 59804-7408
Mailing address
PO Box 7609
Missoula, MT 59807-7609
Phone (406) 721-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057369 | Medicaid | MT |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5347 | MT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1235179508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7609",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598077609",
"telephone_number": "406-721-5600",
"fax_number": "406-721-3907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 FORT MISSOULA ROAD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047408",
"telephone_number": "406-721-5600",
"fax_number": "406-721-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "KATHLEEN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MT",
"license": "5347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0057369",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.