NPIMap

Individual provider Active NPI

Russell Kevin Rogers, MD

  • Family Medicine Physician
  • Scottsburg, IN
National Provider Identifier
1609857259
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01035467 Issued in IN
Practice address
1461 N Gardner St
Scottsburg, IN 47170-7751
Phone
(812) 752-4656
Fax
(812) 752-4919
NPI assigned
Nov 10, 2005
Last updated
Jul 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01035467 IN Primary

Addresses

Primary practice location

1461 N Gardner St
Scottsburg, IN 47170-7751

Mailing address

1461 N Gardner St
PO Box 407
Scottsburg, IN 47170-7751
Phone (812) 752-4656

Other identifiers 2

IdentifierTypeStateIssuer
000000042514OtherKYANTHEM
100221450AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000089 IN Practitioner - Family Practice 4688741150 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsburg, IN

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1473 N Gardner St
Scottsburg, IN 47170-7751
Phone (812) 752-4656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.99 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01035467INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R. Kevin Rogers MD Family Medicine CurrentSince Jan 1, 1990 Accepting new patients

Locations

1473 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-0844

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 2

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.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1609857259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 N GARDNER ST",
            "address_2": "PO BOX 407",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707751",
            "telephone_number": "812-752-4656",
            "fax_number": "812-752-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 N GARDNER ST",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707751",
            "telephone_number": "812-752-4656",
            "fax_number": "812-752-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "RUSSELL",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01035467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000042514",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100221450A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsburg, IN

Sources for this page

Verify at the official NPI Registry.