Individual provider Active NPI

Nicole M Rogers, DPT

  • Physical Therapist
  • Derry, NH
National Provider Identifier
1235249806
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3451 Issued in NH
Practice address
6 Tsienneto Road
Suite 201
Derry, NH 03038-1584
Phone
(603) 421-9959
Fax
(603) 421-9960
NPI assigned
Aug 30, 2006
Last updated
May 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3451 NH Primary

Addresses

Primary practice location

6 Tsienneto Road
Suite 201
Derry, NH 03038-1584

Mailing address

6 Tsienneto Road
Suite 201
Derry, NH 03038-1584
Phone (603) 421-9959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140414000873 NH Practitioner - Physical Therapist in Private Practice 4981739471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monadnock Myofascial Release PLLCGroup PAC ID 7012296221, 5 clinicians

Practice addresses (Care Compare)

103 Roxbury St
Suite 200C
Keene, NH 03431-8802
Phone (603) 355-6637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3451NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Myofascial Release PLLC Physical Therapist CurrentSince Feb 10, 2026 Accepting new patients
Granite Roots Physical Therapy Current Accepting new patients

Locations

103 Roxbury St
Ste 200C
Roxbury, NH 03431
Phone (603) 355-6637

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1235249806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO ROAD",
            "address_2": "SUITE 201",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-421-9959",
            "fax_number": "603-421-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO ROAD",
            "address_2": "SUITE 201",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-421-9959",
            "fax_number": "603-421-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.