Individual provider Active NPI

Shedrick B Rogers

  • Non-emergency Medical Transport (VAN)
  • Jacksonville, FL
National Provider Identifier
1043076839
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
11968 Dover Village Dr N
Jacksonville, FL 32220-3733
Phone
(904) 234-7388
Fax
(904) 379-8122
NPI assigned
Feb 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

11968 Dover Village Dr N
Jacksonville, FL 32220-3733

Mailing address

11968 Dover Village Dr N
Jacksonville, FL 32220-3733
Phone (904) 234-7388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1043076839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11968 DOVER VILLAGE DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322203733",
            "telephone_number": "904-234-7388",
            "fax_number": "904-379-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11968 DOVER VILLAGE DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322203733",
            "telephone_number": "904-234-7388",
            "fax_number": "904-379-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SHEDRICK",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.