Mary Joanne Rodgers

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-52679

Practice address

1460 NW Vivion Rd
Kansas City, MO 64118-4555

Phone

(816) 853-0946

Fax

(816) 396-8809

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Summit Behavioral Services, LLC

  • Assistant Behavior Analyst
  • Kansas City, MO
  • NPI 1376870865
  NPD

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1497417372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 NW VIVION RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184555",
            "telephone_number": "816-853-0946",
            "fax_number": "816-396-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 NW VIVION RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184555",
            "telephone_number": "816-853-0946",
            "fax_number": "816-396-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "MARY",
        "middle_name": "JOANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-52679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-21-52679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Marie Rodenbaugh, LMSW
• Chelsea Sierra Rodenberg, M.D.
• Edith H Roderick, NP
• Rita C Rodgers Stanley, M.D.
• Breanna Rodgers
• James Stephen Rodkey, RT(R)(CT)(MR)
• Deborah Lynn Rodman, APRN
• Matthew Amaral Rodrigues, DDS
• Vinicius Souza Rodrigues, DDS, DMSC
• Bailey Rodriguez

• Behavior Analyst in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.