Individual provider Active NPI

Nicholas James Rogers

  • Psychiatry Physician
  • Peoria, IL
National Provider Identifier
1164086385
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.161219 Issued in IL
Practice address
900 Main St
Peoria, IL 61602-1005
Phone
(309) 672-3100
NPI assigned
Apr 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.161219 IL Primary

Addresses

Primary practice location

900 Main St
Peoria, IL 61602-1005

Mailing address

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719000421 IL Practitioner - Psychiatry 8325408651 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Midwestern University, Chicago College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Practice addresses (Care Compare)

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

900 Main St
Peoria, IL 61602-1060

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.161219ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Psychiatry CurrentSince Jul 1, 2023 Accepting new patients
Proctor Health Systems CurrentSince Jul 1, 2023 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems CurrentSince Jul 1, 2023 Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2023 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients

Locations

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

900 Main St
Ste 400
Peoria, IL 61602
Phone (309) 671-3100

815 Main St
Ste A1
Peoria, IL 61602

900 Main St
Peoria, IL 61602
Phone (309) 672-3100

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: nrogersdo388599@carlehiedirect.net

Organizations & group practices 7

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 4

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1164086385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021005",
            "telephone_number": "309-672-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.161219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.