Active NPI
John Rogers, MD
- Family Medicine Physician
- The Dalles, OR
National Provider Identifier
1821178245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD150489
- Practice address
- 1935 E 19TH St Ste 100
The Dalles, OR 97058-3392 - Phone
- (541) 296-7677
- Fax
- (541) 296-7206
- NPI assigned
- Oct 17, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H3742 | TX | |
| Family Medicine Physician | 207Q00000X | MD150489 | OR | Primary |
Addresses
Primary practice location
1935 E 19TH St Ste 100
The Dalles, OR 97058-3392
Mailing address
1935 E 19TH St Ste 100
PO Box 1520
The Dalles, OR 97058-3392
Phone (541) 296-7677
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126487102 | Medicaid | TX | |
| 500632165 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Columbia Medical Center | Family Medicine | Past | Accepting new patients |
| Baylor College of Medicine | Past | Accepting new patients |
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.
-
dba Adventist Health Columbia Gorge
- Rural Health Clinic/Center
- The Dalles, OR
- NPI 1154351336
Family Medicine
-
dba Baylor College of Medicine Dept of Otolaryngology Head and Neck Cons
- Otolaryngology Physician
- Houston, TX
- NPI 1093880437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1821178245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 E 19TH ST STE 100",
"address_2": "PO BOX 1520",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583392",
"telephone_number": "541-296-7677",
"fax_number": "541-296-7206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 E 19TH ST STE 100",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583392",
"telephone_number": "541-296-7677",
"fax_number": "541-296-7206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H3742",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD150489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126487102",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500632165",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Dalles, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.