Individual provider Active NPI

Nolan Rogers, PHARMD

  • Pharmacist
  • Springfield, IL
National Provider Identifier
1407528540
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051303552 Issued in IL
Practice address
2760 N Dirksen Pkwy
Springfield, IL 62702-1448
Phone
(217) 522-4054
NPI assigned
Sep 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051303552 IL Primary

Addresses

Primary practice location

2760 N Dirksen Pkwy
Springfield, IL 62702-1448

Mailing address

1949 Ramada Blvd Apt 7
Collinsville, IL 62234-6211

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051303552ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1407528540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 RAMADA BLVD APT 7",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622346211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 N DIRKSEN PKWY",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627021448",
            "telephone_number": "217-522-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "NOLAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051303552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "2760 N Dirksen Pkwy",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627021448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.