Individual provider Active NPI

Samantha Rae Rogers, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1417679226
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R198756 Issued in MD
Practice address
5755 Cedar LN
Columbia, MD 21044-2999
Phone
(410) 740-7890
NPI assigned
Sep 19, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R198756 MD Primary

Addresses

Primary practice location

5755 Cedar LN
Columbia, MD 21044-2999

Mailing address

9515 Sylvan Still Rd Apt a
Laurel, MD 20723-1542
Phone (518) 248-2515

Other identifiers 1

IdentifierTypeStateIssuer
R198756OtherMDNURSE PRACTITIONER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20221028002738 MD Practitioner - Nurse Practitioner 0042687352 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
Telehealth
Offers telehealth services
Group practices
Arundel Mental Health Professionals LCGroup PAC ID 4981688173, 118 clinicians

Practice addresses (Care Compare)

8258 Veterans Hwy
Suite 13
Millersville, MD 21108-1564
Phone (410) 768-6088

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arundel Mental Health Professionals L.C. CurrentSince Dec 16, 2024 Accepting new patients
Johns Hopkins University CurrentSince Nov 1, 2022 Accepting new patients
Johns Hopkins University Psychiatric/Mental Health CurrentSince Nov 1, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

1662 Village Grn
#B
Crofton, MD 21114

8258 Veterans Hwy
Ste 13
Millersville, MD 21108
Phone (410) 768-6088

10755 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.samantharogers@149037.advancedmd-direct.com
  • Direct secure messaging: srogers10012@direct.hopkinsmedicine.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1417679226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 SYLVAN STILL RD APT A",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231542",
            "telephone_number": "518-248-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442999",
            "telephone_number": "410-740-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R198756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "R198756",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.