Individual provider Active NPI

Dennis John Rodden, DC

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1619086675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE 4500 Issued in MO
Practice address
2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone
(636) 946-2244
Fax
(636) 946-6975
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE 4500 MO Primary

Addresses

Primary practice location

2621 Raymond Dr
Saint Charles, MO 63301-4872

Mailing address

2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone (636) 946-2244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091123000483 MO Practitioner - Chiropractic 3678623667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Health Centers PCGroup PAC ID 4981681467, 5 clinicians

Practice addresses (Care Compare)

2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone (636) 946-2244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE 4500MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Depression Clinic at the Health Centers Current Accepting new patients

Locations

2621 Raymond Dr
Saint Charles, MO 63301
Phone (636) 946-2244

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619086675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 RAYMOND DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014872",
            "telephone_number": "636-946-2244",
            "fax_number": "636-946-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 RAYMOND DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014872",
            "telephone_number": "636-946-2244",
            "fax_number": "636-946-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDEN",
        "first_name": "DENNIS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE 4500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.