Individual provider Active NPI

Joshua Joseph Rodgers, M.D.

  • Behavioral Neurology & Neuropsychiatry Physician
  • Edwards, CO
National Provider Identifier
1477879237
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
License
DR.0064434 Issued in CO
Practice address
2205 Cordillera Way
Edwards, CO 81632-6290
Phone
(970) 693-0015
NPI assigned
Apr 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X P9713 TX
Psychiatry Physician 2084P0800X DR.0064434 CO
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X DR.0064434 CO Primary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X P9713 TX

Addresses

Primary practice location

2205 Cordillera Way
Edwards, CO 81632-6290

Mailing address

2205 Cordillera Way
Edwards, CO 81632-6290
Phone (970) 693-0015

Other practice location 1

1360 Walnut St Ste 110
Boulder, CO 80302-5399
Phone (303) 848-3635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220429000546 CO Practitioner - PsychiatryPractitioner - Neuropsychiatry 5597051789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P9713TXMDBehavioral Neurology & Neuropsychiatry Physician
DR.0064434COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Reach Center, Inc CurrentSince Apr 1, 2022 Accepting new patients
Community Reach Center, Inc CurrentSince Apr 1, 2022 Accepting new patients
Edwards Medical Provider Group Psychiatry PastSince Dec 13, 2020 Accepting new patients

Locations

8931 Huron St
Thornton, CO 80260
Phone (303) 853-3433

1870 W 122nd Ave
Ste 100
Westminster, CO 80234
Phone (303) 853-3800

Organizations & group practices 3

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1477879237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CORDILLERA WAY",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816326290",
            "telephone_number": "970-693-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 CORDILLERA WAY",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816326290",
            "telephone_number": "970-693-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 Walnut St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803025399",
            "country_code": "US",
            "telephone_number": "303-848-3635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "JOSHUA",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P9713",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0064434",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "CO",
            "license": "DR.0064434",
            "primary": true
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "TX",
            "license": "P9713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.