Kenneth C. Rodgers, PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1114662501 Issued in UT

Legal business name

KENNETH C. RODGERS, PH.D., P.C.

Practice address

8160 Highland Dr
# 102
Sandy, UT 84093-6492

Phone

(801) 943-3319

NPI assigned

Jul 23, 2006

Last updated

Oct 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth C. Rodgers, PH.D.NPI 1134306558

Title

Clinical Psychologist

Phone

(801) 943-3319

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth C. Rodgers, PH.D.

  • Clinical Psychologist
  • Sandy, UT
  • NPI 1134306558
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1841212727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8160 HIGHLAND DR",
            "address_2": "# 102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936492",
            "telephone_number": "801-943-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 HIGHLAND DR",
            "address_2": "# 102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936492",
            "telephone_number": "801-943-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH C. RODGERS, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "801-943-3319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "1114662501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529563429016",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christian Jay Kettering
• Key Speech Therapy LLC
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• Clinical Psychologist in Sandy, UT
• Providers in Sandy, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.