DR. JERRY WHARTON RODGERS (NPI# 1942218359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942218359 |
| Entity Type | Individual |
| Full Name | DR. JERRY WHARTON RODGERS |
| Credential | M.D. |
| Practice Address |
18780 Interstate 20 Canton TX 75103-3593 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035677748 |
| Mailing Telephone | 9033246450 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2014-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | D5180 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 039171606 | 05 | |
| TX | BCBS | 86426F | 01 |
| TX | RAIL ROAD | P01069945 | 01 |
| TX | 039171607 | 05 | |
| TX | 1701864-01 | 05 | |
| TX | TRICARE | 752616977028 | 01 |
| TX | BCBS OF TEXAS | 8V0575 | 01 |
| TX | TRICARE | 752616977001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538454061 | Jerry Rodgers II | Pharmacist | 7378 Fayette Blvd, Chippewa Lake, OH 44215-9812 | 2011-06-13 |
| 1902435209 | Jerry Leonard Rodgers IIi | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-07 |
| Street Address |
18780 INTERSTATE 20 |
| City | CANTON |
| State | TX |
| Zip Code | 75103-3593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396745758 | Michael Wayne Deeds | Physician Assistant | 18780 Interstate 20, Canton, TX 75103-3593 | 2005-07-28 |
| 1245657824 | Angela Burrus | Nurse Practitioner | 18780 Interstate 20, Canton, TX 75103-3593 | 2014-03-21 |
| 1407294101 | Emily Ann Dosier | Family Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2013-06-05 |
| 1649596867 | Georgia Ann Womble | Physician Assistant | 18780 Interstate 20, Canton, TX 75103-3593 | 2010-04-13 |
| 1467693200 | Sheryl Ann Busch | Internal Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2009-03-06 |
| 1134313083 | Christus Trinity Clinic | Clinic/Center | 18780 Interstate 20, Canton, TX 75103-3593 | 2007-09-04 |
| 1316048994 | Bradford James White | Nurse Practitioner | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-09-26 |
| 1417991340 | Kevin Nixon | Emergency Medicine | 18780 Interstate 20, Canton, TX 75103 | 2006-06-14 |
| 1841231446 | Virginia Yolanda Gonzalez | Internal Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-06-08 |
| 1720052566 | Kenneth Wayne Nixon | Family Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265095202 | Brandi Jo Foster | Nurse Practitioner | 4437 Etheride Circle, Canton, TX 75103 | 2019-04-16 |
| 1124595087 | Melissa Williams | Nurse Practitioner | 1108 So. Buffalo St, Canton, TX 75103 | 2018-10-30 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1568945921 | Kelsey Lauren Nixon | Registered Nurse | 5640 Vzcr 4106, Canton, TX 75103 | 2018-09-12 |
| 1649770496 | Chelsea Boshart | Registered Nurse | 150 Vz Cr 4130, Canton, TX 75103 | 2018-02-19 |
| 1396292918 | Deanne Wheeler | Hearing Instrument Specialist | 150 E. Dallas Street, Canton, TX 75103 | 2016-09-01 |
| 1356701221 | Betsy Jill Chappell | Nurse Practitioner | 406 Tx-243, Canton, TX 75103 | 2016-03-04 |
| 1326435199 | Forever Kids Pediatric Clinic | Clinic/Center | 182 Privatet Road 6413, Canton, TX 75103 | 2015-04-20 |
| 1417255233 | Dallas County Hospital District | Skilled Nursing Facility | 1901 S Trade Days Blvd, Canton, TX 75103 | 2011-03-02 |
| 1922243906 | Brookshire Grocery Company | Pharmacy | 880 E State Highway 243, Canton, TX 75103 | 2008-12-05 |
| Find all providers in zip 75103 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1396342606 | Kiwi Virtual Health Care Pllc | Family Medicine | 40618 Blythefield Ln, Canton, MI 48188-2251 | 2020-10-08 |
| 1417571142 | K Loor Medical LLC | Family Medicine | 1750 Marietta Hwy Ste 250, Canton, GA 30114-8388 | 2020-05-28 |
| 1336762913 | Favor Family Medical Practice | Family Medicine | 103 Mountain Brook Dr Ste 100, Canton, GA 30115-9078 | 2020-05-18 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1073012118 | Mea Primary Care Plus LLC | Family Medicine | 112 Southlake Cir, Canton, MS 39046-5368 | 2018-02-05 |
| 1629592175 | Healthy U Academy, LLC | Family Medicine | 1226 Market Ave N, Canton, OH 44714-2604 | 2017-07-26 |
| 1629508114 | Zeinab M Makki | Family Medicine | 7330 N Canton Center Rd Ste 111, Canton, MI 48187-1538 | 2017-06-15 |
| 1366805210 | Michael Wowk | Family Medicine | 1600 S Canton Center Rd Ste 220, Canton, MI 48188-6276 | 2016-03-29 |
| 1184036832 | Courtney Weaver | Family Medicine | 15 Reinhardt College Pkwy Ste 100, Canton, GA 30114-5259 | 2014-05-29 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.