Individual provider Active NPI

David Farris Rogge, M.A., L.A.D.C.

  • Addiction (Substance Use Disorder) Counselor
  • Coon Rapids, MN
National Provider Identifier
1235479247
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
303099 Issued in MN
Practice address
2473 103Rd LN NW
Coon Rapids, MN 55433-4528
Phone
(763) 323-6646
NPI assigned
Feb 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303099 MN Primary

Addresses

Primary practice location

2473 103Rd LN NW
Coon Rapids, MN 55433-4528

Mailing address

2473 103Rd LN NW
Coon Rapids, MN 55433-4528
Phone (763) 323-6646

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
303099MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1235479247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2473 103RD LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334528",
            "telephone_number": "763-323-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2473 103RD LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334528",
            "telephone_number": "763-323-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGGE",
        "first_name": "DAVID",
        "middle_name": "FARRIS",
        "name_prefix": "Mr.",
        "credential": "M.A., L.A.D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.