NPIMap

Individual provider Active NPI

Aeryn Elise Rogers, DO

  • Diagnostic Radiology Physician
  • Jackson, MS
National Provider Identifier
1336636067
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
31336 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4505
Phone
(601) 815-1779
Fax
(601) 815-0444
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 31336 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4505

Mailing address

504 Clinton Center Dr Ste 4300
Clinton, MS 39056-5610
Phone (601) 815-2005

Other names 1

  • Elijah Rogers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230520000205 MS Practitioner - Diagnostic Radiology 9931459153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Alabama College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claiborne County HospitalGroup PAC ID 0244394385, 16 clinicians

Practice addresses (Care Compare)

123 McComb Ave
Port Gibson, MS 39150-2915
Phone 60143751412267

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
31336MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Jul 1, 2023 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

Interoperability endpoints

  • Direct secure messaging: erogers88325@ummc.direct-ci.com
  • Direct secure messaging: elijah.rogers.1@20428.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1336636067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DR STE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "601-815-2005",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505",
            "telephone_number": "601-815-1779",
            "fax_number": "601-815-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "AERYN",
        "middle_name": "ELISE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "31336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIJAH",
            "last_name": "ROGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.