Active NPI
Edwin Samuel Rogers, PHD, ABPP
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1578521613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P740
- Practice address
- 1924 Alcoa Hwy
U-115
Knoxville, TN 37920-1511 - Phone
- (865) 544-9351
- Fax
- (865) 544-9314
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
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 Psychologist | 103TC0700X | P740 | TN | Primary |
Addresses
Primary practice location
1924 Alcoa Hwy
U-115
Knoxville, TN 37920-1511
Mailing address
1924 Alcoa Hwy
U-67
Knoxville, TN 37920-1511
Phone (865) 544-9352
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TN01H8 | Other | TN | JOHN DEERE |
| 3373352 | Other | TN | UFP MEDICAID GRP |
| 680011669 | Other | RAILROAD MEDICARE | |
| 3373352 | Other | TN | UFP MEDICARE GRP |
| 1689631137 | Other | TN | GROUP NPI |
| 3680230 | Other | TN | AETNA |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P740 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1578521613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1924 ALCOA HWY",
"address_2": "U-67",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201511",
"telephone_number": "865-544-9352",
"fax_number": "865-544-9314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1924 ALCOA HWY",
"address_2": "U-115",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201511",
"telephone_number": "865-544-9351",
"fax_number": "865-544-9314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "EDWIN",
"middle_name": "SAMUEL",
"credential": "PHD, ABPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN01H8",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UFP MEDICAID GRP",
"identifier": "3373352",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "680011669",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UFP MEDICARE GRP",
"identifier": "3373352",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1689631137",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3680230",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.