Individual provider Active NPI

Amanda Rae Rogers, FNP-C

  • Family Nurse Practitioner
  • Hopkinsville, KY
National Provider Identifier
1336790260
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013886 Issued in KY
Practice address
320 W 18TH St
Hopkinsville, KY 42240-1965
Phone
(270) 887-0100
NPI assigned
Sep 23, 2019
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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 3013886 KY Primary
Registered Nurse 163W00000X 0000229755 TN

Addresses

Primary practice location

320 W 18TH St
Hopkinsville, KY 42240-1965

Mailing address

3827 Man O War Blvd
Clarksville, TN 37042-7270
Phone (270) 881-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191125002406 KY Practitioner - Nurse Practitioner 3476986886 Reassigns benefits to 2 organizations
I20220325001689 TN Practitioner - Nurse Practitioner 3476986886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fep of Kentucky LLCGroup PAC ID 8123473626, 21 clinicians

Practice addresses (Care Compare)

320 W 18TH St
Hopkinsville, KY 44240-1965
Phone (505) 287-4446

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000229755TNMDRegistered Nurse
3013886KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC CurrentSince Jul 28, 2020 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 31, 2022 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 31, 2022 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jul 28, 2020 Accepting new patients
Fep of Kentucky LLC CurrentSince Sep 2, 2023 Accepting new patients

Locations

110 W John Rowan Blvd
Bardstown, KY 40004
Phone (502) 337-7409

2955 Fort Campbell Blvd
Hopkinsville, KY 42240
Phone (270) 632-1548

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1336790260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 MAN O WAR BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427270",
            "telephone_number": "270-881-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 18TH ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401965",
            "telephone_number": "270-887-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013886",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000229755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.