Active NPI
Roger John Casey Jr., ATC
- Addiction (Substance Use Disorder) Counselor
- Scandia, MN
National Provider Identifier
1730428699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 304448
- Practice address
- 12280 228TH St N
Scandia, MN 55073-9467 - Phone
- (651) 399-8497
- NPI assigned
- Feb 12, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1109 | MN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304448 | MN | Primary |
Addresses
Primary practice location
12280 228TH St N
Scandia, MN 55073-9467
Mailing address
12280 228TH St N
Scandia, MN 55073-9467
Phone (651) 399-8497
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304448 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 1109 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1730428699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12280 228TH ST N",
"city": "SCANDIA",
"state": "MN",
"postal_code": "550739467",
"telephone_number": "651-399-8497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12280 228TH ST N",
"city": "SCANDIA",
"state": "MN",
"postal_code": "550739467",
"telephone_number": "651-399-8497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASEY",
"first_name": "ROGER",
"middle_name": "JOHN",
"name_suffix": "Jr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-12",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "1109",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "304448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scandia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.