Individual provider Active NPI

Katherine Eugenia Rogers, NP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1033589544
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9272329 Issued in FL
Practice address
4615 Philips Hwy Ste 3
Jacksonville, FL 32207-9539
Phone
(904) 508-0710
Fax
(855) 299-7010
NPI assigned
Sep 28, 2015
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9272329 FL Primary

Addresses

Primary practice location

4615 Philips Hwy Ste 3
Jacksonville, FL 32207-9539

Mailing address

Dept. #394
P.O. Box 1000
Memphis, TN 38148-0001
Phone (941) 366-0134

Other practice location 1

1435 Dunn Ave Ste 101
Daytona Beach, FL 32114-1434
Phone (386) 274-7651

Other identifiers 2

IdentifierTypeStateIssuer
IR051XOtherFLMEDICARE
015884800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160519000898 FL Practitioner - Nurse Practitioner 9830488519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4440 Fruitville Rd
Sarasota, FL 34232-1926

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
90.03
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9272329FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Can Community Health Inc. CurrentSince May 15, 2018 Accepting new patients
Can Community Health, Inc. Family CurrentSince May 15, 2018 Accepting new patients
Can Community Health, Inc. Past Accepting new patients

Locations

1435 Dunn Ave
Ste 101
Daytona Beach, FL 32114
Phone (386) 274-7651

4615 Philips Hwy
Ste 3
Jacksonville, FL 32207
Phone (904) 508-0710

4440 Fruitville Rd
Sarasota, FL 34232
Phone (941) 366-0134

1231 N Tuttle Ave
Sarasota, FL 34237
Phone (941) 366-0134

Interoperability endpoints

  • Direct secure messaging: katherine.rogers@can.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1033589544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. #394",
            "address_2": "P.O. BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "941-366-0134",
            "fax_number": "941-404-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HWY STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079539",
            "telephone_number": "904-508-0710",
            "fax_number": "855-299-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1435 Dunn Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321141434",
            "country_code": "US",
            "telephone_number": "386-274-7651",
            "fax_number": "877-242-5455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KATHERINE",
        "middle_name": "EUGENIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9272329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IR051X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015884800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.