Individual provider Active NPI

Erin Rogers, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1548080906
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP030433 Issued in PA
Practice address
561 Fairthorne Ave
Philadelphia, PA 19128-2412
Phone
(215) 487-4000
NPI assigned
Oct 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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 SP030433 PA Primary

Addresses

Primary practice location

561 Fairthorne Ave
Philadelphia, PA 19128-2412

Mailing address

561 Fairthorne Ave Unit 1
Philadelphia, PA 19128-2412
Phone (267) 939-7624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241206003712 PA Practitioner - Nurse Practitioner 6406382928 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030433PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

561 Fairthorne Ave
Unit 1
Philadelphia, PA 19128

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1548080906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE UNIT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "267-939-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ERIN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP030433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.