Individual provider Active NPI

Michael Dennis Rogers, PT

  • Physical Therapist
  • D'Iberville, MS
National Provider Identifier
1730427956
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0207 Issued in MS
Practice address
3680 Sangani Blvd
Suite D
Diberville, MS 39540-8703
Phone
(601) 714-0315
Fax
(601) 714-0316
NPI assigned
Jan 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT0207 MS Primary

Addresses

Primary practice location

3680 Sangani Blvd
Suite D
Diberville, MS 39540-8703

Mailing address

2781 CT Switzer Drive
Suite 404
Biloxi, MS 39531
Phone (228) 575-2598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130628000499 MS Practitioner - Physical Therapist in Private Practice 3173763943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centric Physical Therapy LLCGroup PAC ID 7113299603, 2 clinicians

Practice addresses (Care Compare)

16120 Landon Rd
Gulfport, MS 39503-6119
Phone (228) 831-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Center of Ocean Springs, LLC Physical Therapist CurrentSince Jan 23, 2020 Accepting new patients
Centric Physical Therapy LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

16120 Landon Rd
Gulfport, MS 39503
Phone (228) 831-5830

900 Holcomb Blvd
#A
Ocean Springs, MS 39564
Phone (228) 872-6821

Organizations & group practices 2

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": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1730427956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 CT SWITZER DRIVE",
            "address_2": "SUITE 404",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39531",
            "telephone_number": "228-575-2598",
            "fax_number": "228-594-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 SANGANI BLVD",
            "address_2": "SUITE D",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395408703",
            "telephone_number": "601-714-0315",
            "fax_number": "601-714-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MICHAEL",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in D'Iberville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.