Active NPI
Michael Rodgers
- Clinical Social Worker
- San Luis Obispo, CA
National Provider Identifier
1558718072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 71140
- Practice address
- 3000 Augusta St Apt 152
San Luis Obispo, CA 93401-5836 - Phone
- (805) 602-6719
- NPI assigned
- May 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 71140 | CA | Primary |
Addresses
Primary practice location
3000 Augusta St Apt 152
San Luis Obispo, CA 93401-5836
Mailing address
3000 Augusta St Apt 152
San Luis Obispo, CA 93401-5836
Phone (805) 602-6719
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463356800000",
"number": "1558718072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 AUGUSTA ST APT 152",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934015836",
"telephone_number": "805-602-6719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 AUGUSTA ST APT 152",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934015836",
"telephone_number": "805-602-6719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-16",
"last_updated": "2016-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "71140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.