Individual provider Active NPI

Reginald L. Rodges, D.C.

  • Chiropractor
  • Cleveland, MS
National Provider Identifier
1699865501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0950 Issued in MS
Practice address
124 North St
Cleveland, MS 38732-2744
Phone
(662) 843-0076
Fax
(662) 846-7730
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

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 0950 MS Primary

Addresses

Primary practice location

124 North St
Cleveland, MS 38732-2744

Mailing address

124 North St
Cleveland, MS 38732-2744
Phone (662) 843-0076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000330 MS Practitioner - Chiropractic 2961567938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 N St
Cleveland, MS 38732-2744
Phone (662) 843-0076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0950MSMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Pain Back Institute, LLC Chiropractor CurrentSince Oct 2, 2011 Accepting new patients

Locations

124 North St
Cleveland, MS 38732
Phone (662) 843-0076

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699865501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NORTH ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322744",
            "telephone_number": "662-843-0076",
            "fax_number": "662-846-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NORTH ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322744",
            "telephone_number": "662-843-0076",
            "fax_number": "662-846-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGES",
        "first_name": "REGINALD",
        "middle_name": "L.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

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.