Individual provider Active NPI

Haley M Rogers, FNP-C

  • Nurse Practitioner
  • Rusk, TX
National Provider Identifier
1386340727
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1107554 Issued in TX
Practice address
1400 N Dickinson Dr
Rusk, TX 75785-1000
Phone
(903) 683-0500
Fax
(430) 300-1140
NPI assigned
Feb 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1107554 TX Primary

Addresses

Primary practice location

1400 N Dickinson Dr
Rusk, TX 75785-1000

Mailing address

3900 NE Stallings Dr Ste 101
Nacogdoches, TX 75965-2111
Phone (936) 559-8770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230309002734 TX Practitioner - Nurse Practitioner 8123491230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Tyler, TX 75701-1952
Phone (903) 595-6680

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Nov 1, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Nov 1, 2023 Accepting new patients
Cline Family Practice PastSince Feb 12, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

3900 NE Stallings Dr
Ste 101
Nacogdoches, TX 75965
Phone (936) 249-1866

701 Olympic Plaza Cir
Ste 510
Tyler, TX 75701

700 Olympic Plaza Cir
Ste 508
Tyler, TX 75701
Phone (903) 526-3030

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1000 E 5th St
Ste 100
Tyler, TX 75701
Phone (903) 590-5000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGIHAD

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 3

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": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1386340727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NE STALLINGS DR STE 101",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652111",
            "telephone_number": "936-559-8770",
            "fax_number": "936-559-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N DICKINSON DR",
            "city": "RUSK",
            "state": "TX",
            "postal_code": "757851000",
            "telephone_number": "903-683-0500",
            "fax_number": "430-300-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "HALEY",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1107554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rusk, TX

Sources for this page

Verify at the official NPI Registry.