Individual provider Active NPI

Vanessa Rogong, NP

  • Nurse Practitioner
  • Carson, CA
National Provider Identifier
1245935063
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024303 Issued in CA
Practice address
22027 Gulf Ave
Carson, CA 90745
Phone
(310) 729-5118
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95024303 CA Primary

Addresses

Primary practice location

22027 Gulf Ave
Carson, CA 90745

Mailing address

22027 Gulf Ave
Carson, CA 90745
Phone (310) 729-5118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002147 CA Practitioner - Nurse Practitioner 1052770658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

22027 Gulf Ave
Carson, CA 90745-3042

2228 W Great Neck Rd
Suite 205
Virginia Beach, VA 23451-1674

5901 W Century Blvd
Suite 750
Los Angeles, CA 90045-5443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024303CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Wound Care CurrentSince Dec 1, 2024 Accepting new patients
Homecare Wound Care Services CurrentSince Jan 25, 2025 Accepting new patients
Global Wound Care Medical Group CurrentSince Jun 12, 2023 Accepting new patients

Locations

1400 Mountain Ave
Ste J
Duarte, CA 91010
Phone (888) 699-9997

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

136 E Walnut Ave
Monrovia, CA 91016
Phone (323) 803-3284

180 Promenade Cir
Ste 300
Sacramento, CA 95834
Phone (916) 352-6232

1651 Response Rd
Ste 350
Sacramento, CA 95815
Phone (818) 450-1188

Organizations & group practices 3

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1245935063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22027 GULF AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90745",
            "telephone_number": "310-729-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22027 GULF AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90745",
            "telephone_number": "310-729-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGONG",
        "first_name": "VANESSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.