Individual provider Active NPI

Justin Rogers, CRNP

  • Primary Care Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1003581620
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP024208 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 782-3131
NPI assigned
Aug 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP024208 PA Primary

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

111 S Front St
Harrisburg, PA 17101-2010
Phone (877) 321-2963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230308001293 ID Practitioner - Nurse Practitioner 5597154625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Diabetes and Osteoporosis Center PAGroup PAC ID 5890750483, 15 clinicians

Practice addresses (Care Compare)

3910 Washington Pkwy
Idaho Falls, ID 83404-7596
Phone (208) 523-1122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RM Lab LLC Current Accepting new patients
Rocky Mountain Diabetes and Osteoporosis Center PA Endocrinology, Diabetes & Metabolism CurrentSince Feb 1, 2023 Accepting new patients

Locations

3910 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 522-2996

444 Hospital Way
Ste 112
Pocatello, ID 83201

444 Hospital Way
Ste 600
Pocatello, ID 83201
Phone (208) 295-2221

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEFDAA
  • Direct secure messaging: justin.rogers.1@33233.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1003581620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "877-321-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JUSTIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP024208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.