Individual provider Active NPI

Susan Rogers

  • Community Health Worker
  • Toledo, OH
National Provider Identifier
1083353890
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1219 Jefferson Ave
Toledo, OH 43604-5836
Phone
(567) 289-2273
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X Primary

Addresses

Primary practice location

1219 Jefferson Ave
Toledo, OH 43604-5836

Mailing address

1219 Jefferson Ave
Toledo, OH 43604-5836
Phone (567) 289-2273

Other identifiers 1

IdentifierTypeStateIssuer
1679721906MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
National Youth Advocate Program, Inc Multi-Specialty CurrentSince Jun 5, 2022 Accepting new patients
National Youth Advocate Program, Inc Multi-Specialty PastSince Jun 5, 2022 Accepting new patients

Locations

1219 Jefferson Ave
Toledo, OH 43604
Phone (567) 289-2273

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1083353890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045836",
            "telephone_number": "567-289-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045836",
            "telephone_number": "567-289-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679721906",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.