Individual provider Active NPI

Anne Tucker Rodgers, PA-C

  • Physician Assistant
  • Shelby, NC
National Provider Identifier
1194262436
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07010 Issued in NC
Practice address
808 Schenck St
Shelby, NC 28150-3934
Phone
(704) 480-1087
NPI assigned
Jan 25, 2017
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07010 NC Primary

Addresses

Primary practice location

808 Schenck St
Shelby, NC 28150-3934

Mailing address

1809 Queen St
Fayetteville, NC 28303-4337
Phone (252) 673-2436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170417000631 NC Practitioner - Physician Assistant 9638455264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

133 1St Ave SE
Hickory, NC 28602-3005
Phone (828) 994-4544

991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07010NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc CurrentSince Mar 23, 2022 Accepting new patients
Gaston Family Health Services, Inc. CurrentSince Mar 23, 2022 Accepting new patients
Fayetteville Plastic Surgery Specialists, PA Past Accepting new patients
Gaston Family Health Services, Inc. Past Accepting new patients

Locations

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

133 1st Ave SE
Hickory, NC 28602
Phone (828) 944-4544

5009 Fallston Rd
Lawndale, NC 28090
Phone (704) 480-9344

808 Schenck St
Shelby, NC 28150
Phone (704) 480-9344

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1194262436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 QUEEN ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034337",
            "telephone_number": "252-673-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 SCHENCK ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503934",
            "telephone_number": "704-480-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ANNE",
        "middle_name": "TUCKER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.