Active NPI
Elizabeth B Rogers, MPH, PT
- Physical Therapist
- Wilmington, NC
National Provider Identifier
1083648422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 612
- Practice address
- 1310 Bayside Cir E
Wilmington, NC 28405-4102 - Phone
- (910) 509-2837
- Fax
- (910) 251-2735
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 612 | NC | Primary |
Addresses
Primary practice location
1310 Bayside Cir E
Wilmington, NC 28405-4102
Mailing address
1310 Bayside Cir E
Wilmington, NC 28405-4102
Phone (910) 509-2837
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 720788P | Medicaid | NC | |
| 0788P | Other | NC | BC/BS PROVIDER NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 612 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1083648422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 BAYSIDE CIR E",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284054102",
"telephone_number": "910-509-2837",
"fax_number": "910-251-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 BAYSIDE CIR E",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284054102",
"telephone_number": "910-509-2837",
"fax_number": "910-251-2735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "ELIZABETH",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "MPH, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "720788P",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "0788P",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.