Individual provider Active NPI

Jennifer Lucille Rogers, APRN, FNP-BC

  • Family Nurse Practitioner
  • Dunnville, KY
National Provider Identifier
1104485630
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013440 Issued in KY
Practice address
10739 S US 127
Dunnville, KY 42528-6037
Phone
(606) 787-3405
Fax
(606) 787-3404
NPI assigned
Jun 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 3013440 KY Primary

Addresses

Primary practice location

10739 S US 127
Dunnville, KY 42528-6037

Mailing address

10739 S US 127
Dunnville, KY 42528-6037
Phone (606) 787-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190925002641 KY Practitioner - Nurse Practitioner 2961732417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013440KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC CurrentSince Aug 5, 2021 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Aug 5, 2021 Accepting new patients
Alternative Health Solutions LLC PastSince Jan 26, 2025 Accepting new patients

Locations

110 W John Rowan Blvd
Bardstown, KY 40004
Phone (502) 337-7409

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

2520 S Highway 27
Somerset, KY 42501
Phone (606) 416-5719

Organizations & group practices 3

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": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1104485630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10739 S US 127",
            "city": "DUNNVILLE",
            "state": "KY",
            "postal_code": "425286037",
            "telephone_number": "606-787-3405",
            "fax_number": "606-787-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10739 S US 127",
            "city": "DUNNVILLE",
            "state": "KY",
            "postal_code": "425286037",
            "telephone_number": "606-787-3405",
            "fax_number": "606-787-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JENNIFER",
        "middle_name": "LUCILLE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunnville, KY

Sources for this page

Verify at the official NPI Registry.