Individual provider Active NPI

Bret Kyle Rogers

  • Acupuncturist
  • San Antonio, TX
National Provider Identifier
1598246233
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01804 Issued in TX
Practice address
1502 S Flores St
San Antonio, TX 78204-1638
Phone
(512) 450-4228
NPI assigned
Aug 21, 2018
Last updated
Aug 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01804 TX Primary

Addresses

Primary practice location

1502 S Flores St
San Antonio, TX 78204-1638

Mailing address

PO Box 831361
San Antonio, TX 78283-1361
Phone (512) 450-4228

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
AC01804TXMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Raven Acupuncture, PLLC Acupuncturist CurrentSince Oct 16, 2022 Accepting new patients

Locations

4212 San Pedro Ave
Ste 101
San Antonio, TX 78212
Phone (210) 912-4766

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1598246233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 831361",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782831361",
            "telephone_number": "512-450-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S FLORES ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041638",
            "telephone_number": "512-450-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "BRET",
        "middle_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.