Individual provider Active NPI

Candice T Rogers, RN NP

  • Nurse Practitioner
  • Dublin, GA
National Provider Identifier
1548574338
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN168119 Issued in GA
Practice address
1000 Hillcrest Pkwy
Dublin, GA 31021
Phone
(478) 277-0214
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN168119 GA
Nurse Practitioner 363L00000X RN168119 GA Primary

Addresses

Primary practice location

1000 Hillcrest Pkwy
Dublin, GA 31021

Mailing address

900 Mohawk St Ste E
Savannah, GA 31419-1768
Phone (912) 925-0067

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crogers@gscc.encitedirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101229001030 GA Practitioner - Nurse Practitioner 6800084203 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN168119GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sidney P Smith MD PC CurrentSince Mar 15, 2021 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Oct 28, 2019 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Oct 28, 2019 Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221

900 Mohawk St
Ste E
Savannah, GA 31419

900 Mohawk St
Ste F
Savannah, GA 31419

1096 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-5150

Interoperability endpoints

  • Direct secure messaging: crogers@gscc.encitedirect.com

Organizations & group practices 3

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1548574338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191768",
            "telephone_number": "912-925-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "31021",
            "telephone_number": "478-277-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CANDICE",
        "middle_name": "T",
        "credential": "RN  NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN168119",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN168119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crogers@gscc.encitedirect.com",
            "affiliation": "N",
            "address_1": "900 Mohawk St Ste E",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314191768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.