Individual provider Active NPI

Daniel Paul Rogers

  • Case Management Registered Nurse
  • Redondo Beach, CA
National Provider Identifier
1255986667
Registry record updated Aug 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
95043872 Issued in CA
Practice address
409 N Pacific Coast Hwy Ste 590
Redondo Beach, CA 90277-6853
Phone
(213) 213-5171
NPI assigned
Aug 3, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 95043872 CA Primary

Addresses

Primary practice location

409 N Pacific Coast Hwy Ste 590
Redondo Beach, CA 90277-6853

Mailing address

409 N Pacific Coast Hwy Ste 590
Redondo Beach, CA 90277-6853

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

State licenses

LicenseStateTypeSpecialty
95043872CAMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1564790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564790400000",
    "number": "1255986667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N PACIFIC COAST HWY STE 590",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N PACIFIC COAST HWY STE 590",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776853",
            "telephone_number": "213-213-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "DANIEL",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-03",
        "last_updated": "2019-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "95043872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.

Verify at the official NPI Registry.