Provider Demographics
NPI:1508152331
Name:ROGERS, DANIEL (CNA, CMA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:CNA, CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E CURTIS DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-5809
Mailing Address - Country:US
Mailing Address - Phone:405-886-6874
Mailing Address - Fax:
Practice Address - Street 1:510 E CURTIS DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-5809
Practice Address - Country:US
Practice Address - Phone:405-886-6874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 172A00000X, 171WH0202X, 172V00000X, 1744G0900X, 1744P3200X, 174V00000X, 372500000X, 253Z00000X, 372600000X, 373H00000X, 3747A0650X, 3747P1801X, 390200000X
OK37H0299B1010376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No376K00000XNursing Service Related ProvidersNurse's Aide
No171WH0202XOther Service ProvidersContractorHome Modifications
No172V00000XOther Service ProvidersCommunity Health Worker
No1744G0900XOther Service ProvidersSpecialistGraphics Designer
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No174V00000XOther Service ProvidersClinical Ethicist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program