Individual provider Active NPI

David Rodgers, PA-C

  • Physician Assistant
  • Fort Carson, CO
National Provider Identifier
1972903458
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60815222 Issued in WA
Practice address
1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone
(719) 524-6517
NPI assigned
Sep 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP60080597 WA
Military Health Care Provider 171000000X 1145181
Physician Assistant 363A00000X PA60815222 WA Primary

Addresses

Primary practice location

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604

Mailing address

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone (719) 524-6517

Other identifiers 1

IdentifierTypeStateIssuer
2121865MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
LP60080597WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1972903458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-03",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60080597",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": "1145181",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60815222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121865",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.