Individual provider Active NPI

Stuart Douglas Rogers, O.D.

  • Optometrist
  • Henderson, TN
National Provider Identifier
1811959265
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT857 Issued in TN
Practice address
124 N Washington Ave
Henderson, TN 38340-1800
Phone
(731) 989-2711
Fax
(731) 989-2778
NPI assigned
Apr 3, 2006
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT857 TN Primary

Addresses

Primary practice location

124 N Washington Ave
Henderson, TN 38340-1800

Mailing address

124 N Washington Ave
P.O. Box 159
Henderson, TN 38340-1800
Phone (731) 989-2711

Other identifiers 1

IdentifierTypeStateIssuer
3596038MedicaidTN

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100901000385 TN Practitioner - Optometry 0345364089 Practice locations: Henderson, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 N Washington Ave
Henderson, TN 38340-0159
Phone (731) 989-2711

124 N Washington Ave
Henderson, TN 38340-1800

P O Box
Suite 159
Henderson, TN 38340-0159

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart D Rogers, OD Optometrist CurrentSince Jun 26, 1993 Accepting new patients

Locations

124 N Washington Ave
Henderson, TN 38340
Phone (731) 989-2711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1811959265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N WASHINGTON AVE",
            "address_2": "P.O. BOX 159",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383401800",
            "telephone_number": "731-989-2711",
            "fax_number": "731-989-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N WASHINGTON AVE",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383401800",
            "telephone_number": "731-989-2711",
            "fax_number": "731-989-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "STUART",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3596038",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.