Phyllis Lashley Rodgers

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

121190 Issued in FL

Practice address

3947 Boulevard Center Dr Ste 5
Jacksonville, FL 32207-2833

Phone

(904) 470-9965

Fax

(904) 375-2768

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• St. Philomena Assisted Living Facilities, LLC

  • Assisted Living Facility (Mental Illness)
  • Orange Park, FL
  • NPI 1679966873

  Assisted Living, Mental Illness

  NPD (past) Authorized official

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1235521956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3947 BOULEVARD CENTER DR STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072833",
            "telephone_number": "904-470-9965",
            "fax_number": "904-375-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 BOULEVARD CENTER DR STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072833",
            "telephone_number": "904-470-9965",
            "fax_number": "904-375-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "PHYLLIS",
        "middle_name": "LASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL12632",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "121190",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "121190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delvon Rodgers
• Elise Rodgers
• Ingrid Rodgers, CRNA
• Kyle James Rodgers, AUD
• Mary Patricia Rodgers
• Tonya Rodgers
• William Harry Rodgers, D.PH.
• Adrian Rodicio, DO
• Courtney Rodman, PT
• Chehairazode Alvenetta Rodney, LMHC

• Nurse's Aide in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse's Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.