Individual provider Active NPI

Michael Joe Rodgerson, PH.D.

  • Clinical Psychologist
  • Lincoln, NE
National Provider Identifier
1710005442
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
88 Issued in NE
Practice address
7441 O St
Suite 402
Lincoln, NE 68510-2466
Phone
(402) 483-4215
Fax
(402) 483-5228
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 88 NE Primary

Addresses

Primary practice location

7441 O St
Suite 402
Lincoln, NE 68510-2466

Mailing address

10610 Carena Cir
Fort Myers, FL 33913-6818
Phone (402) 440-9941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106002172 FL Practitioner - Clinical Psychologist 9638108988 Practice locations: Bonita Springs, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9990 Coconut Rd
Suite 322
Estero, FL 34135-8488
Phone (402) 440-9941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
88NEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Orthopaedic Center PC Past Accepting new patients

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1710005442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10610 CARENA CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339136818",
            "telephone_number": "402-440-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7441 O ST",
            "address_2": "SUITE 402",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102466",
            "telephone_number": "402-483-4215",
            "fax_number": "402-483-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERSON",
        "first_name": "MICHAEL",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "88",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.