Basic Information
| Provider Information | |||||||||
| NPI: | 1780654665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 S MINNESOTA AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571053761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 S. CLIFF AVE. | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053224425 | ||||||||
| FaxNumber: | 6053224499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 4560 | SD | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 040130007 | 01 | MN | PRIMEWEST | OTHER | HP32540 | 01 | SD | HEALTHPARTNERS | OTHER | 0533695 | 05 | IA | MEDICAID | 22326 | 01 | SD | MIDLAND'S CHOICE | OTHER | 62B58RO | 01 | MN | CC SYSTEMS/BLUE PLUS | OTHER | 57105L006 | 01 | SD | WPS TRICARE | OTHER | 9145659 | 01 | SD | DAKOTACARE | OTHER | 250745500 | 05 | MN | MEDICAID | 4700118 | 05 | NE | MEDICAID | 6701340 | 05 | SD | MEDICAID | 800762 | 01 | SD | ARAZ/AMERICA'S PPO | OTHER | 140311 | 01 | MN | UCARE | OTHER | 46022474345 | 05 | NE | MEDICAID | 0007025 | 01 | SD | BLUE CROSS/SOUTH DAKOTA | OTHER | 34577 | 01 | SD | SANFORD HEALTH | OTHER | 4700076 | 01 | SD | MEDICA | OTHER | 769221022962 | 01 | SD | PREFERRED ONE | OTHER |