Individual provider Active NPI

Rodger Wesley Massa, DC

  • Chiropractor
  • St Johns, MI
National Provider Identifier
1992830038
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
RM005731 Issued in MI
Practice address
1004 N US 27
St Johns, MI 48879
Phone
(989) 224-8228
Fax
(989) 224-2157
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X RM005731 MI Primary

Addresses

Primary practice location

1004 N US 27
St Johns, MI 48879

Mailing address

1004 N US 27
St Johns, MI 48879
Phone (989) 224-8228

Other identifiers 3

IdentifierTypeStateIssuer
2000000002355OtherPHP
950A95135OtherBC
2712107MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000380 MI Practitioner - Chiropractic 8123102670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1004 N US Hwy 27
Saint Johns, MI 48879-1129
Phone (989) 224-8228

Hospital & facility affiliations

  • University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RM005731MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Chiropractic Clinic, Inc. Chiropractor CurrentSince Oct 1, 2007 Accepting new patients

Locations

1004 N US Highway 27
Saint Johns, MI 48879
Phone (517) 224-8228

Organizations & group practices 1

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 1

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1992830038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 N US 27",
            "city": "ST JOHNS",
            "state": "MI",
            "postal_code": "48879",
            "telephone_number": "989-224-8228",
            "fax_number": "989-224-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N US 27",
            "city": "ST JOHNS",
            "state": "MI",
            "postal_code": "48879",
            "telephone_number": "989-224-8228",
            "fax_number": "989-224-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSA",
        "first_name": "RODGER",
        "middle_name": "WESLEY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "RM005731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "2000000002355",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "950A95135",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2712107",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.