Individual provider Active NPI

Carol Eisenhauer Rogers, GNP-BC

  • Gerontology Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1306107354
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.0992961-NP Issued in CO
Practice address
8280 Montgomery Rd
Suite 306
Cincinnati, OH 45236-6101
Phone
(937) 499-3567
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN.0992961-NP CO Primary

Addresses

Primary practice location

8280 Montgomery Rd
Suite 306
Cincinnati, OH 45236-6101

Mailing address

6455 S Yosemite St FL 6
Greenwood Village, CO 80111-5139
Phone (719) 728-0365

Other practice location 1

5920 McIntyre St
Golden, CO 80403-7445
Phone (720) 434-4876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20180308001166 CO Practitioner - Nurse Practitioner 6709019995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0992961-NPCOMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1306107354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 S YOSEMITE ST FL 6",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115139",
            "telephone_number": "719-728-0365",
            "fax_number": "844-881-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8280 MONTGOMERY RD",
            "address_2": "SUITE 306",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452366101",
            "telephone_number": "937-499-3567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5920 McIntyre St",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804037445",
            "country_code": "US",
            "telephone_number": "720-434-4876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CAROL",
        "middle_name": "EISENHAUER",
        "name_prefix": "Mrs.",
        "credential": "GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0992961-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.