Individual provider Active NPI

David B Rogers, M.D.

  • Orthopaedic Surgery Physician
  • Bolivar, MO
National Provider Identifier
1790766558
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
R9H97 Issued in MO
Practice address
1155 W. Parkview St.
Suite 2D
Bolivar, MO 65613-7800
Phone
(417) 777-2663
Fax
(417) 777-2666
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R9H97 MO Primary

Addresses

Primary practice location

1155 W. Parkview St.
Suite 2D
Bolivar, MO 65613-7800

Mailing address

1155 W. Parkview St.
Suite 2D
Bolivar, MO 65613-7800
Phone (417) 777-2663

Other identifiers 3

IdentifierTypeStateIssuer
202569430MedicaidMO
R9H97OtherMOSTATE LICENSE NUMBER
200964600AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000478 MO Practitioner - Orthopedic Surgery 4688625882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-7800

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

Hospital & facility affiliations

  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R9H97MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Jun 1, 2003 Accepting new patients
Citizens Memorial Healthcare Orthopaedic Surgery CurrentSince Jun 1, 2003 Accepting new patients
Mercy Clinic Joplin LLC PastSince Sep 1, 2012 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1245 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6000

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1155 W Parkview St
Ste 2D
Bolivar, MO 65613
Phone (417) 777-2663

855 Arduser Dr
Osceola, MO 64776
Phone (417) 646-5075

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1790766558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 W. PARKVIEW ST.",
            "address_2": "SUITE 2D",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656137800",
            "telephone_number": "417-777-2663",
            "fax_number": "417-777-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W. PARKVIEW ST.",
            "address_2": "SUITE 2D",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656137800",
            "telephone_number": "417-777-2663",
            "fax_number": "417-777-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R9H97",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202569430",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "R9H97",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200964600A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.