Stanley Kim Rogers, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2514 Issued in SC

Practice address

11 Professionals Cir
Seneca, SC 29678

Phone

(864) 882-0134

Fax

(864) 882-0135

NPI assigned

Mar 1, 2007

Reactivated

Dec 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1730217852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONALS CIR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "29678",
            "telephone_number": "864-882-0134",
            "fax_number": "864-882-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONALS CIR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "29678",
            "telephone_number": "864-882-0134",
            "fax_number": "864-882-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "STANLEY",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-12-18",
        "deactivation_date": "2007-03-22",
        "reactivation_date": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "2514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole E Ritter, RN, APRN
• Jennifer Roberts, MHRD, ATC
• Melina Robertson, MA CF SLP
• Tabetha Robinson, RN-BSN
• Marcia Joan Rochette, RN
• Ronald R. Moore, D.M.D., P.a.
• Micaela Roper, LISW-CP
• Rosa Clark Medical Center
• Susan Gail Rose
• Ronald Roseman, MD

• Dentist in Seneca, SC
• Providers in Seneca, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.