NPIMap

Individual provider Active NPI

Libby Leininger Rogers, ARNP

  • Family Nurse Practitioner
  • Tahlequah, OK
National Provider Identifier
1043409865
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
74414 Issued in OK
Practice address
529 N. Oak St
Tahlequah, OK 74464-2925
Phone
(918) 444-2126
Fax
(918) 458-2300
NPI assigned
Oct 17, 2007
Last updated
Jun 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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 74414 OK Primary

Addresses

Primary practice location

529 N. Oak St
Tahlequah, OK 74464-2925

Mailing address

PO Box 751
Hulbert, OK 74441-0751
Phone (918) 444-2250

Other identifiers 1

IdentifierTypeStateIssuer
200131110AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080407000169 OK Practitioner - Nurse Practitioner 9234216888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 E Downing St
Suite 214
Tahlequah, OK 74464-3379
Phone (918) 431-0202

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74414OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Community Health Centers Inc Current Accepting new patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Jul 1, 2016 Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc CurrentSince Jul 1, 2016 Accepting new patients
Northeastern Health System Past Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc. Past Accepting new patients
Tracey W. Childers, D.O. P.C. Past Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc Past Accepting new patients

Locations

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

1500 E Downing St
Ste 102
Tahlequah, OK 74464
Phone (918) 207-0773

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

1500 E Downing St
Ste 214
Tahlequah, OK 74464
Phone (918) 413-0202

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1043409865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "HULBERT",
            "state": "OK",
            "postal_code": "744410751",
            "telephone_number": "918-444-2250",
            "fax_number": "918-444-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 N. OAK ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642925",
            "telephone_number": "918-444-2126",
            "fax_number": "918-458-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LIBBY",
        "middle_name": "LEININGER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "74414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200131110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.