Camilla Rogers, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3551 Issued in NC

Practice address

121 N Center St Ste 202
Statesville, NC 28677-5388

Phone

(704) 380-0436

Fax

(866) 950-6464

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1174539688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 WENDOVER RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773141",
            "telephone_number": "704-380-0436",
            "fax_number": "866-950-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N CENTER ST STE 202",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775388",
            "telephone_number": "704-380-0436",
            "fax_number": "866-950-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CAMILLA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "3551",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2826089",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maribel Robles, SLP-CCC
• Dustin Thomas Roe, PHARMD
• Katherine Ashe Roethling, LCSWA
• Roger L Roark, MD PA
• Ashley Card Rogers, RN
• Lyndsay Rogers
• Sonya Lynn Rogers, FNP
• Donnielle Lauren Rome-Martin, OTR/L
• Allen Joseph Romeo, PH.D
• Rebecca White Romeo, LPC

• Clinical Psychologist in Statesville, NC
• Providers in Statesville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.