Individual provider Active NPI

Kelly Marie Rogers

  • Family Nurse Practitioner
  • Washington, MO
National Provider Identifier
1184265753
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019021309 Issued in MO
Practice address
901 Patients First Dr Ste 2000
Washington, MO 63090-4700
Phone
(636) 390-1684
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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 2019021309 MO Primary

Addresses

Primary practice location

901 Patients First Dr Ste 2000
Washington, MO 63090-4700

Mailing address

2352 Brookview Dr
Washington, MO 63090-5110
Phone (314) 749-3642

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL EPIC Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20191217003244 MO Practitioner - Nurse Practitioner 9830523240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

851 E 5TH St
Washington, MO 63090-3130

901 Patients 1St Dr
Washington, MO 63090-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019021309MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Current Accepting new patients
Mercy Clinic East Communities CurrentSince Dec 1, 2019 Accepting new patients

Locations

7345 Watson Rd
Ste 201
Saint Louis, MO 63119
Phone (314) 752-7100

901 Patients First Dr
Ste 2000
Washington, MO 63090
Phone (636) 239-7344

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Organizations & group practices 2

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 3

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1184265753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 BROOKVIEW DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905110",
            "telephone_number": "314-749-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR STE 2000",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-390-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019021309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "901 Patients First Dr Ste 2000",
            "city": "Washington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630904700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.