Individual provider Active NPI

Jason Scott Rogers, DMD

  • Dentist
  • Laurens, SC
National Provider Identifier
1609980036
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4024 Issued in SC
Practice address
810 E Main St
Suite G
Laurens, SC 29360-3535
Phone
(864) 715-0688
NPI assigned
Aug 19, 2006
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4024 SC Primary

Addresses

Primary practice location

810 E Main St
Suite G
Laurens, SC 29360-3535

Mailing address

810 E Main St Ste G
Laurens, SC 29360-3547
Phone (864) 200-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201120000308 SC Practitioner - Dentist 9436462900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Laurens Dentistry, LLC Current Accepting new patients

Locations

810 E Main St
Ste G
Laurens, SC 29360
Phone (864) 715-0688

Organizations & group practices 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1609980036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E MAIN ST STE G",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603547",
            "telephone_number": "864-200-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E MAIN ST",
            "address_2": "SUITE G",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603535",
            "telephone_number": "864-715-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurens, SC

Sources for this page

Verify at the official NPI Registry.