Individual provider Active NPI

Daniel G Rogers, PHD

  • Clinical Psychologist
  • North Kingstown, RI
National Provider Identifier
1780304402
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS0209 Issued in RI
Practice address
1130 Ten Rod Rd Ste E305
North Kingstown, RI 02852-4176
Phone
(012) 940-4514
Fax
(401) 294-0461
NPI assigned
Sep 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS02097 RI
Clinical Psychologist 103TC0700X PS0209 RI Primary

Addresses

Primary practice location

1130 Ten Rod Rd Ste E305
North Kingstown, RI 02852-4176

Mailing address

1130 Ten Rod Rd Ste E305
N Kingstown, RI 02852-4176
Phone (401) 294-0451

Other practice location 1

278 Orange St Apt 4
New Haven, CT 06510-1722
Phone (651) 233-8560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20221202002415 RI Practitioner - Clinical Psychologist 2264801885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS02097RIMDPsychologist
PS0209RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 25, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 25, 2024 Accepting new patients

Locations

400 Massasoit Ave
Ste 305
East Providence, RI 02914
Phone (401) 268-5218

1130 Ten Rod Rd
Ste E305
North Kingstown, RI 02852
Phone 4012940451824

1130 Ten Rod Rd
Bldg E
North Kingstown, RI 02852

1130 Ten Rod Rd
North Kingstown, RI 02852
Phone (401) 268-3886

Interoperability endpoints

  • Direct secure messaging: dan.rogers.1@28623.direct.athenahealth.com

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1780304402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD STE E305",
            "city": "N KINGSTOWN",
            "state": "RI",
            "postal_code": "028524176",
            "telephone_number": "401-294-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD STE E305",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524176",
            "telephone_number": "012-940-4514",
            "fax_number": "401-294-0461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "278 Orange St Apt 4",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065101722",
            "country_code": "US",
            "telephone_number": "651-233-8560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "DANIEL",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS02097",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS0209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kingstown, RI

Sources for this page

Verify at the official NPI Registry.