Jacob Vernon Rodgers

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

110 Skyline Dr
Russellville, AR 72801-3362

Phone

(479) 968-1298

Fax

(479) 968-6053

NPI assigned

Nov 24, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1295063501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 E 16TH ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728022648",
            "telephone_number": "479-967-2022",
            "fax_number": "479-967-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013362",
            "telephone_number": "479-968-1298",
            "fax_number": "479-968-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "JACOB",
        "middle_name": "VERNON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Robertson, MD
• Kelli L Robinson, SLP
• Rachel E. Mikles Robinson, CCC-SLP
• Victor Roble, CIT
• Brynn Rodgers
• Brandi Leigh Rogers, LCSW
• Randi Ellen Rogers
• Suzanne Lynnette Rogers, ST
• Gabrielle Rolen
• Michael Andrew Roller, PHARM.D.

• All providers in Russellville, AR
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.