Individual provider Active NPI

Ernest Eugene Rogers, AUDIOLOGY ASSISTANT

  • Audiology Assistant
  • Fort Leonard Wood, MO
National Provider Identifier
1629386834
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiology AssistantTaxonomy code 2355A2700X
License
077302A Issued in MO
Practice address
126 Missouri Ave
Fortleonardwood, MO 65473
Phone
(573) 596-0131
NPI assigned
Sep 22, 2010
Last updated
Sep 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiology Assistant 2355A2700X 077302A MO Primary

Addresses

Primary practice location

126 Missouri Ave
Fortleonardwood, MO 65473

Mailing address

126 Missouri Ave
Fortleonardwood, MO 65473
Phone (573) 596-0131

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
077302AMOMDAudiology Assistant

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1629386834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "city": "FORTLEONARDWOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "city": "FORTLEONARDWOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ERNEST",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "AUDIOLOGY ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355A2700X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Audiology Assistant",
            "state": "MO",
            "license": "077302A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.