Individual provider Active NPI

Susan Hart Rogerson, M.D.

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1184631376
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E1407 Issued in AR
Practice address
767 W North St
Fayetteville, AR 72701-1865
Phone
(479) 521-3600
Fax
(479) 521-7422
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E1407 AR Primary

Addresses

Primary practice location

767 W North St
Fayetteville, AR 72701-1865

Mailing address

PO Box 8056
Fayetteville, AR 72703-0001
Phone (479) 841-8878

Other identifiers 1

IdentifierTypeStateIssuer
133207001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100909001203 AR Practitioner - General PracticePractitioner - Family Practice 5890810113 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1407ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHG L, LLC CurrentSince Apr 1, 2020 Accepting new patients
BHG L, LLC CurrentSince Apr 1, 2020 Accepting new patients
BHG L, LLC Current Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients

Locations

255 E College St
Batesville, AR 72501
Phone (870) 569-9862

1058 Front St
Ste 104
Conway, AR 72032
Phone (501) 504-2092

82 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 282-2992

1501 S Waldron Rd
Ste 203
Fort Smith, AR 72903
Phone (479) 769-2880

1 Mercy Ln
Ste 403
Hot Springs National Park, AR 71913
Phone (501) 319-7963

5510 Southwest Dr
Ste 8
Jonesboro, AR 72404
Phone (870) 520-6313

2231 Trinity Blvd
Texarkana, AR 71854
Phone (870) 330-3210

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1184631376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8056",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030001",
            "telephone_number": "479-841-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 W NORTH ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011865",
            "telephone_number": "479-521-3600",
            "fax_number": "479-521-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERSON",
        "first_name": "SUSAN",
        "middle_name": "HART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133207001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.