Shirley Gwen Rogerson, MPH,BSN,RN,CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

9170975 Issued in FL

Practice address

4710 S Florida Ave
Lakeland, FL 33813-2165

Phone

(863) 284-3950

Fax

(863) 284-3951

NPI assigned

Feb 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1407355217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-284-1604",
            "fax_number": "863-687-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132165",
            "telephone_number": "863-284-3950",
            "fax_number": "863-284-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERSON",
        "first_name": "SHIRLEY",
        "middle_name": "GWEN",
        "credential": "MPH,BSN,RN,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "RN9170975",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "917905",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "9170975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Ann Roeper, BCBA
• Alexia Annalee Rogers, ARNP FNP-BC
• Billy Rogers, ARNP, CRNA
• Jasmine Rogers
• Kelly Rogers
• Grissell Rojas, CRNA
• Tiffany Ann Rojas
• Alex Rola, D.O.
• Abageal Ann Roland-Steinke
• Dylia Roland

• Diabetes Educator Registered Nurse in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Diabetes Educator Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.