Individual provider Active NPI

Channien Lanet Rogers, FNP

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1063991677
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F03200318 Issued in TN
Practice address
5180 Park Ave Ste 250
Memphis, TN 38119-3535
Phone
(731) 432-9812
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 60575983 WA
Family Nurse Practitioner 363LF0000X F03200318 TN Primary

Addresses

Primary practice location

5180 Park Ave Ste 250
Memphis, TN 38119-3535

Mailing address

5180 Park Ave Ste 250
Memphis, TN 38119-3535

Other practice location 1

516 176th St E
Spanaway, WA 98387-8335
Phone (253) 683-6000

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
I20221222001652 TN Practitioner - Nurse Practitioner 1052781655 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60575983WAMDSchool Registered Nurse
F03200318TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Tennessee LLC Family CurrentSince Dec 19, 2022 Accepting new patients

Locations

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1063991677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 PARK AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 PARK AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193535",
            "telephone_number": "731-432-9812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 176th St E",
            "address_purpose": "LOCATION",
            "city": "Spanaway",
            "state": "WA",
            "postal_code": "983878335",
            "country_code": "US",
            "telephone_number": "253-683-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CHANNIEN",
        "middle_name": "LANET",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "60575983",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F03200318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.