Individual provider Active NPI

Leslie Corrine Rogers, NP

  • Family Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1134407489
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1090A Issued in ID
Practice address
428 6TH Ave
Lewiston, ID 83501-2355
Phone
(208) 263-9757
Fax
(208) 965-8128
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-1090A ID
Family Nurse Practitioner 363LF0000X NP-1090A ID Primary
Nurse Practitioner 363L00000X AP61006462 WA

Addresses

Primary practice location

428 6TH Ave
Lewiston, ID 83501-2355

Mailing address

1327 W Superior St Ste 101
Sandpoint, ID 83864-2742
Phone (208) 245-9566

Other practice location 1

1327 W Superior St Ste 101
Sandpoint, ID 83864-2742
Phone (208) 263-9757

Other practice location 2

1113 E Westview Ct
Spokane, WA 99218-1319
Phone (208) 263-9757

Other identifiers 1

IdentifierTypeStateIssuer
2013847MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131004000112 ID Practitioner - Nurse Practitioner 4981838034 Reassigns benefits to 1 organization
I20201106000537 WA Practitioner - Nurse Practitioner 4981838034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Idaho Pain Clinic PLLCGroup PAC ID 3274712609, 9 clinicians

Practice addresses (Care Compare)

1113 E Westview CT
Spokane, WA 99218-1319
Phone (208) 263-9757

229 S 7TH St
St Maries, ID 83861-1803
Phone (208) 263-9757

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.58 of 100Reported as group
Quality
54.82
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-1090AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Pain Clinic PLLC CurrentSince May 1, 2018 Accepting new patients

Locations

428 6th Ave
Lewiston, ID 83501
Phone (208) 263-9757

1110 E Polston Ave
Ste 3
Post Falls, ID 83854
Phone (208) 263-9757

1327 W Superior St
Ste 101
Sandpoint, ID 83864
Phone (208) 263-9757

229 S 7th St
St Maries, ID 83861
Phone (208) 245-2591

714 W Pine St
Newport, WA 99156
Phone (509) 447-2441

1113 E Westview Ct
Spokane, WA 99218
Phone (208) 263-9757

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73383

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1134407489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 W SUPERIOR ST STE 101",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642742",
            "telephone_number": "208-245-9566",
            "fax_number": "208-245-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 6TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012355",
            "telephone_number": "208-263-9757",
            "fax_number": "208-965-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 W Superior St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sandpoint",
            "state": "ID",
            "postal_code": "838642742",
            "country_code": "US",
            "telephone_number": "208-263-9757",
            "fax_number": "208-965-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 E Westview Ct",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992181319",
            "country_code": "US",
            "telephone_number": "208-263-9757",
            "fax_number": "208-965-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LESLIE",
        "middle_name": "CORRINE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-1090A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1090A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61006462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013847",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.