NPIMap

Individual provider Active NPI

Shelly M Rogers, MD

  • Internal Medicine Physician
  • Winchester, KY
National Provider Identifier
1497795116
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38934 Issued in KY
Practice address
1520 Boonesboro Rd
Winchester, KY 40391-8816
Phone
(859) 744-0067
Fax
(859) 744-0042
NPI assigned
Jun 8, 2006
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38934 KY Primary

Addresses

Primary practice location

1520 Boonesboro Rd
Winchester, KY 40391-8816

Mailing address

3819 Black Creek Rd
Clay City, KY 40312-9510
Phone (859) 432-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000290 KY Practitioner - Internal Medicine 6305875444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ertel Medicine and Pediatrics, PSCGroup PAC ID 1759272479, 3 clinicians

Practice addresses (Care Compare)

1520 Boonesboro Rd
Winchester, KY 40391-8816

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38934KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Regional Physician Practices, LLC Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Clark Regional Physician Practices LLC CurrentSince Mar 1, 2023 Accepting new patients
Gateway Recovery Clinic, PLLC Past Accepting new patients
Thomas C. Thornberry, M.D., LLC Past Accepting new patients
Kentucky Hospital, LLC Past Accepting new patients
Clark Regional Physician Practices LLC Past Accepting new patients

Locations

1520 Boonesboro Rd
Winchester, KY 40391
Phone (859) 744-0067

1520 Boonesboro Rd
Ste 1
Winchester, KY 40391

225 Hospital Dr
Winchester, KY 40391
Phone (859) 737-8528

225 Hospital Dr
Ste 200A
Winchester, KY 40391
Phone (859) 737-6480

Interoperability endpoints

  • Direct secure messaging: shelly.rogers.1@19475.direct.athenahealth.com

Organizations & group practices 6

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 8

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1497795116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 BLACK CREEK RD",
            "city": "CLAY CITY",
            "state": "KY",
            "postal_code": "403129510",
            "telephone_number": "859-432-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BOONESBORO RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918816",
            "telephone_number": "859-744-0067",
            "fax_number": "859-744-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SHELLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "38934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

Verify at the official NPI Registry.