Organization Active NPI

Rogers Dermatology, PA

  • Procedural Dermatology Physician
  • Greenville, SC
National Provider Identifier
1912950775
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
6924 Issued in SC
Legal business name
ROGERS DERMATOLOGY, PA
Practice address
3B Cleveland CT
Greenville, SC 29607-2414
Phone
(864) 351-0332
Fax
(864) 351-0373
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Nina C Godfrey
Title
Office Manager
Phone
(864) 351-0332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X 6924 SC Primary

Addresses

Primary practice location

3B Cleveland CT
Greenville, SC 29607-2414

Mailing address

3B Cleveland CT
Greenville, SC 29607-2414
Phone (864) 351-0332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000442 SC Part B Supplier - Clinic/Group Practice 3678526746 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Locations

3B Cleveland Ct
Greenville, SC 29607
Phone (864) 232-0196

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1912950775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3B CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-351-0332",
            "fax_number": "864-351-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3B CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-351-0332",
            "fax_number": "864-351-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGERS DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-351-0332"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "SC",
            "license": "6924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.