Shanda Desha Rogers, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2222 Issued in AR

Practice address

1900 Stillwater Dr
Jonesboro, AR 72404-9119

Phone

(870) 932-3600

Fax

(870) 932-3611

NPI assigned

Jan 29, 2007

Last updated

Jul 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Miracle Kids Success Academy

  • Speech-Language Pathologist
  • Jonesboro, AR
  • NPI 1184945701

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1053457226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 MARTINBROOK DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015923",
            "telephone_number": "870-931-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STILLWATER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049119",
            "telephone_number": "870-932-3600",
            "fax_number": "870-932-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SHANDA",
        "middle_name": "DESHA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARBCBS",
            "identifier": "5Y298",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142528721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Rogers, LSW
• Jordan Nicole Rogers, DNP, APRN
• Joseph Blake Rogers, PTA
• Kelly Dawn Rogers, APN
• Penny Mellard Rogers, LCSW
• Tosha D Rogers
• Whitney Rolland
• Ronald S Burnett DDS PA
• Ryan A Ropp, LCSW
• Sarah Rorex

• Physical Therapist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.