Provider Demographics
NPI:1073267100
Name:RODGERS, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:RODGERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9706 BEXLEY FARMS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4901
Mailing Address - Country:US
Mailing Address - Phone:804-433-5112
Mailing Address - Fax:
Practice Address - Street 1:6513 IRON BRIDGE PL
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-5300
Practice Address - Country:US
Practice Address - Phone:804-433-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No171W00000XOther Service ProvidersContractor
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility