Individual provider Active NPI

Jill Ellen Rogacki, ATC

  • Athletic Trainer
  • Wauseon, OH
National Provider Identifier
1346372893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2200 Issued in OH
Practice address
138 E Elm St
Wauseon, OH 43567-1457
Phone
(419) 335-1919
Fax
(419) 335-1921
NPI assigned
Mar 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2200 OH Primary

Addresses

Primary practice location

138 E Elm St
Wauseon, OH 43567-1457

Mailing address

307 Majestic Dr
Toledo, OH 43608-1164
Phone (734) 347-6853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2200OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
R & F Inc Past Accepting new patients
R & F Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346372893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 MAJESTIC DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436081164",
            "telephone_number": "734-347-6853",
            "fax_number": "419-335-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 E ELM ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671457",
            "telephone_number": "419-335-1919",
            "fax_number": "419-335-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGACKI",
        "first_name": "JILL",
        "middle_name": "ELLEN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.