Active NPI
Evelyn Virginia Rogers
- Addiction (Substance Use Disorder) Counselor
- Saint Louis, MO
National Provider Identifier
1124539978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0897
- Practice address
- 12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346 - Phone
- (800) 325-3982
- Fax
- (888) 685-9880
- NPI assigned
- Oct 19, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0897 | GA | Primary |
Addresses
Primary practice location
12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346
Mailing address
12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346
Phone (800) 325-3982
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 |
|---|---|---|---|
| 0897 | GA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1124539978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12647 OLIVE BLVD STE 600",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416346",
"telephone_number": "800-325-3982",
"fax_number": "888-685-9880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12647 OLIVE BLVD STE 600",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416346",
"telephone_number": "800-325-3982",
"fax_number": "888-685-9880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "EVELYN",
"middle_name": "VIRGINIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-19",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "0897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.