NPIMap

Individual provider Active NPI

Clinton E Rogers, MD

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1922289859
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301078081 Issued in MI
Practice address
3264 N Evergreen Drive NE
Grand Rapids, MI 49525
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
Nov 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301078081 MI Primary

Addresses

Primary practice location

3264 N Evergreen Drive NE
Grand Rapids, MI 49525

Mailing address

3264 N Evergreen Drive NE
Grand Rapids, MI 49525
Phone (616) 363-7272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080109000014 MI Practitioner - Diagnostic Radiology 8325128911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

700 Cooper Ave
Saginaw, MI 48602-5383
Phone (616) 363-7272

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078081MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. CurrentSince Oct 3, 2010 Accepting new patients
Covenant Medical Center, Inc Diagnostic Radiology CurrentSince Oct 3, 2010 Accepting new patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

844 Washington Ave
Holland, MI 49423
Phone (616) 355-3820

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

3400 N Center Rd
Ste 400
Saginaw, MI 48603
Phone (989) 799-5600

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

Interoperability endpoints

  • Direct secure messaging: crogers1149426@direct.hfhs.org

Organizations & group practices 5

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 8

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": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1922289859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DRIVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DRIVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CLINTON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301078081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.