Individual provider Active NPI

Temika Rogers, LCSW

  • Clinical Social Worker
  • Pine Bluff, AR
National Provider Identifier
1245455294
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5469-C Issued in AR
Practice address
813 W 6TH Ave
Pine Bluff, AR 71601-4031
Phone
(870) 568-4502
Fax
(870) 395-7086
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5469-C AR Primary

Addresses

Primary practice location

813 W 6TH Ave
Pine Bluff, AR 71601-4031

Mailing address

PO Box 1926
Pine Bluff, AR 71613-1926
Phone (870) 718-2349

Other identifiers 1

IdentifierTypeStateIssuer
395982YXDKMedicaidAR

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
5469-CARMDClinical Social Worker
105311TXMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Healthcare, LLC PastSince Apr 1, 2019 Accepting new patients

Organizations & group practices 1

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1245455294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1926",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716131926",
            "telephone_number": "870-718-2349",
            "fax_number": "870-395-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 W 6TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014031",
            "telephone_number": "870-568-4502",
            "fax_number": "870-395-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TEMIKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "5469-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395982YXDK",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.