NPIMap

Individual provider Active NPI

Denine Marion Rogers, RD LD

  • Registered Dietitian
  • Douglasville, GA
National Provider Identifier
1225174055
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD001969 Issued in GA
Practice address
1075 Walker Place Drive
Douglasville, GA 30134
Phone
(678) 952-9881
Fax
(770) 693-1185
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD001969 GA Primary

Addresses

Primary practice location

1075 Walker Place Drive
Douglasville, GA 30134

Mailing address

1075 Walker Place Drive
Douglasville, GA 30134
Phone (678) 952-9881

Other identifiers 1

IdentifierTypeStateIssuer
71BBBSJMedicaidGA

Other names 1

  • Ms. Denine Marion Young - Rogers Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1969GAMDInternist Chiropractor
LD001969GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Paces Ferry Medical Group PC Past Accepting new patients
Thaddeus K Lynn, M.D., P.C. Past Accepting new patients
Tapestry Wellness Institute LLC Dietitian, Registered PastSince Apr 3, 2024 Accepting new patients
Diabetes Association of Atlanta Dietitian, Registered Past Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEACAA

Organizations & group practices 7

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1225174055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 WALKER PLACE DRIVE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "678-952-9881",
            "fax_number": "770-693-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 WALKER PLACE DRIVE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "678-952-9881",
            "fax_number": "770-693-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "DENINE",
        "middle_name": "MARION",
        "name_prefix": "Ms.",
        "credential": "RD LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD001969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71BBBSJ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENINE",
            "last_name": "YOUNG - ROGERS",
            "middle_name": "MARION",
            "prefix": "MS.",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.