Individual provider Active NPI

Cheyenne Nicole Rodgers, APRN

  • Family Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1083208276
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011817 Issued in FL
Practice address
4500 W Midway Rd
Fort Pierce, FL 34981-4823
Phone
(772) 370-8081
NPI assigned
Feb 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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 APRN11011817 FL Primary

Addresses

Primary practice location

4500 W Midway Rd
Fort Pierce, FL 34981-4823

Mailing address

6303 S Header Canal Rd
Port Saint Lucie, FL 34987-3119
Phone (772) 370-8081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210405002207 FL Practitioner - Nurse Practitioner 8628485851 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11011817FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizons of the Treasure Coast Inc CurrentSince Apr 5, 2021 Accepting new patients

Locations

4500 W Midway Rd
Fort Pierce, FL 34981
Phone (561) 468-5600

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": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1083208276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6303 S HEADER CANAL RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349873119",
            "telephone_number": "772-370-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814823",
            "telephone_number": "772-370-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "CHEYENNE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.