Individual provider Active NPI

Colleen Kathryn Rogers, ATC

  • Sports Medicine (Emergency Medicine) Physician
  • Cary, NC
National Provider Identifier
1194375808
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
2601001916 Issued in MI
Practice address
1609 Vineyard Mist Dr
Cary, NC 27519-6998
Phone
(919) 475-4613
NPI assigned
Sep 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 2601001916 MI Primary

Addresses

Primary practice location

1609 Vineyard Mist Dr
Cary, NC 27519-6998

Mailing address

1609 Vineyard Mist Dr
Cary, NC 27519-6998
Phone (919) 475-4613

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Personal Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2601001916MIMDSports Medicine (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1194375808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 VINEYARD MIST DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196998",
            "telephone_number": "919-475-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 VINEYARD MIST DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196998",
            "telephone_number": "919-475-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "COLLEEN",
        "middle_name": "KATHRYN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MI",
            "license": "2601001916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Personal",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Charlotte",
            "address_1": "1609 Vineyard Mist Dr",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275196998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.