Individual provider Active NPI

Suzanne B Rogers, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1295830131
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN12112 Issued in TN
Practice address
401 East Main Street
Johnson City, TN 37601-4877
Phone
(423) 929-2584
Fax
(423) 722-2060
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN12112 TN Primary
Family Nurse Practitioner 363LF0000X APN0024169684 VA

Addresses

Primary practice location

401 East Main Street
Johnson City, TN 37601-4877

Mailing address

401 East Main Street
Johnson City, TN 37601-4877
Phone (423) 929-2584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070123000601 TN Practitioner - Nurse Practitioner 5395746085 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN12112TNMDFamily Nurse Practitioner
APN0024169684VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care PLLC CurrentSince Aug 4, 2017 Accepting new patients
Trinity Cancer Care, P.C. Past Accepting new patients
East Tennessee Hematology/Oncology Assoc P.C. Past Accepting new patients

Locations

401 E Main St
Johnson City, TN 37601
Phone (423) 722-2062

Interoperability endpoints

  • Direct secure messaging: suzanne.rogers.1@17374.direct.athenahealth.com

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1295830131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EAST MAIN STREET",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST MAIN STREET",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SUZANNE",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN12112",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "APN0024169684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.