Individual provider Active NPI

Donna R Rogers, PHD

  • Clinical Psychologist
  • Holly Springs, NC
National Provider Identifier
1477538288
Registry record updated May 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4436 Issued in NC
Practice address
1140 Holly Springs Rd
Suite 207
Holly Springs, NC 27540-9634
Phone
(919) 802-0312
Fax
(919) 800-3060
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0332 NV
Clinical Psychologist 103TC0700X 4436 NC Primary

Addresses

Primary practice location

1140 Holly Springs Rd
Suite 207
Holly Springs, NC 27540-9634

Mailing address

3317 Prospect Pkwy
Durham, NC 27703-8359
Phone (702) 374-3282

Other identifiers 2

IdentifierTypeStateIssuer
002602088MedicaidNV
4436OtherNCNC STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0332NVMDClinical Psychologist
4436NCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1477538288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 PROSPECT PKWY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038359",
            "telephone_number": "702-374-3282",
            "fax_number": "919-800-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 HOLLY SPRINGS RD",
            "address_2": "SUITE 207",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409634",
            "telephone_number": "919-802-0312",
            "fax_number": "919-800-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "DONNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0332",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002602088",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "4436",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.