Active NPI
Charles Alfred Rogers, M.D.
- Pediatrics Physician
- Minneapolis, MN
National Provider Identifier
1689681884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20144
- Practice address
- 2545 Chicago Avenue South
Suite 405
Minneapolis, MN 55404-4544 - Phone
- (612) 871-5511
- Fax
- (612) 871-0996
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20144 | MN | Primary |
| Pediatrics Physician | 208000000X | 0414742 | KS | |
| Pediatrics Physician | 208000000X | 19438 | WI |
Addresses
Primary practice location
2545 Chicago Avenue South
Suite 405
Minneapolis, MN 55404-4544
Mailing address
2545 Chicago Avenue South
Suite 405
Minneapolis, MN 55404-4544
Phone (612) 871-5511
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00337001 | Other | MN | PREFERRED ONE |
| V41130100922689 | Other | MN | HEALTHPARTNERS |
| 1200067 | Other | MN | MEDICA HEALTH PLAN |
| 0N261RO | Other | MN | BLUE CROSS BLUE SHIELD MN |
| 111171 | Other | MN | UCARE OF MINNESOTA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0414742 | KS | MD | Pediatrics Physician |
| 20144 | MN | MD | Pediatrics Physician |
| 19438 | WI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689681884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2545 CHICAGO AVENUE SOUTH",
"address_2": "SUITE 405",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044544",
"telephone_number": "612-871-5511",
"fax_number": "612-871-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2545 CHICAGO AVENUE SOUTH",
"address_2": "SUITE 405",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044544",
"telephone_number": "612-871-5511",
"fax_number": "612-871-0996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "CHARLES",
"middle_name": "ALFRED",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "20144",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "0414742",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "19438",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "00337001",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "V41130100922689",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLAN",
"identifier": "1200067",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "0N261RO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE OF MINNESOTA",
"identifier": "111171",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.