Individual provider Active NPI

Elizabeth Rodgers, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jasper, TN
National Provider Identifier
1053494708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7011 Issued in TN
Practice address
215 Hickman Road
Jasper, TN 37347
Phone
(423) 942-3961
Fax
(423) 942-3961
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7011 TN Primary

Addresses

Primary practice location

215 Hickman Road
Jasper, TN 37347

Mailing address

118 N Church St
Murfreesboro, TN 37130-3636
Phone (615) 278-2241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040506001222 TN Practitioner - Nurse Practitioner 0648269605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Development Center, Inc.Group PAC ID 5496768855, 10 clinicians

Practice addresses (Care Compare)

509 N Cedar Ave
Cookeville, TN 38501-1707
Phone (931) 520-8435

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7011TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Development Center, Inc. CurrentSince Jul 17, 2018 Accepting new patients
Volunteer Behavioral Health Care System Past Accepting new patients

Locations

509 N Cedar Ave
Cookeville, TN 38501
Phone (931) 520-8435

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, 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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053494708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N CHURCH ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371303636",
            "telephone_number": "615-278-2241",
            "fax_number": "615-904-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HICKMAN ROAD",
            "city": "JASPER",
            "state": "TN",
            "postal_code": "37347",
            "telephone_number": "423-942-3961",
            "fax_number": "423-942-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ELIZABETH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "7011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TN

Sources for this page

Verify at the official NPI Registry.