Active NPI
Chester Lynn Rogers, M.D.
- Family Medicine Physician
- Bourbon, IN
National Provider Identifier
1689613382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01041632
- Practice address
- 114 N Washington St
Bourbon, IN 46504-1623 - Phone
- (574) 342-2444
- Fax
- (574) 342-2442
- NPI assigned
- Jun 6, 2006
- Last updated
- Nov 25, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01041632 | IN | Primary |
Addresses
Primary practice location
114 N Washington St
Bourbon, IN 46504-1623
Mailing address
707 E Cedar St
Ste 200
South Bend, IN 46617-2057
Phone (574) 472-6700
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01041632 | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Regional Medical Center, Inc. | Past | Accepting new patients |
Interoperability endpoints
- crogers1147596@direct.trinity-health.org
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.
-
dba Saint Joseph Medical Group
- Pulmonary Disease Physician
- Plymouth, IN
- NPI 1225082878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1689613382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E CEDAR ST",
"address_2": "STE 200",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172057",
"telephone_number": "574-472-6700",
"fax_number": "574-472-6746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 N WASHINGTON ST",
"city": "BOURBON",
"state": "IN",
"postal_code": "465041623",
"telephone_number": "574-342-2444",
"fax_number": "574-342-2442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "CHESTER",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01041632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bourbon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.