Individual provider Active NPI

Michelle L Rogers, FNP-C

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1457100869
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28211 Issued in SC
Practice address
5110 Fairfield Rd
Columbia, SC 29203-4323
Phone
(803) 893-7019
NPI assigned
May 16, 2024
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28211 SC Primary
Adult Medicine Physician 207QA0505X 28211 SC

Addresses

Primary practice location

5110 Fairfield Rd
Columbia, SC 29203-4323

Mailing address

PO Box 740013
Atlanta, GA 30374-0013
Phone (312) 733-9730

Other practice location 1

4055 Valley View Ln
Dallas, TX 75244-5074
Phone (855) 984-5121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20241121002015 SC Practitioner - Nurse Practitioner 2961937321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group of South Carolina LLCGroup PAC ID 3375959075, 31 clinicians

Practice addresses (Care Compare)

5110 Fairfield Rd
Columbia, SC 29203-4323
Phone (803) 893-7019

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28211SCMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of South Carolina, LLC Family CurrentSince Sep 16, 2024 Accepting new patients

Locations

5110 Fairfield Rd
Columbia, SC 29203
Phone (803) 691-5650

6119 White Horse Rd
Ste 14
Greenville, SC 29611
Phone (864) 614-7001

Organizations & group practices 1

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 1

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1457100869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740013",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740013",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 FAIRFIELD RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034323",
            "telephone_number": "803-893-7019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Valley View Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752445074",
            "country_code": "US",
            "telephone_number": "855-984-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28211",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "SC",
            "license": "28211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.