Individual provider Active NPI

Candice R Rogers, APRN

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1487217634
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R0087945 Issued in OK
Practice address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone
(918) 744-2345
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Acute Care Nurse Practitioner 363LA2100X R0087945 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Tulsa, OK 74104-4012

Mailing address

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (479) 420-7858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20191122000135 OK Practitioner - Nurse Practitioner 3476985979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-9393

Hospital & facility affiliations

  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
  • Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0087945OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince Oct 1, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1120 S Utica Ave
#G100
Tulsa, OK 74104
Phone (918) 392-0175

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: crogers190433@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1487217634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "479-420-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-744-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CANDICE",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "R0087945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.