Individual provider Active NPI

Lauren Rogers, PA-C

  • Physician Assistant
  • Prescott Valley, AZ
National Provider Identifier
1588016356
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6410 Issued in AZ
Practice address
7875 E Florentine Rd Ste a
Prescott Valley, AZ 86314-2284
Phone
(928) 443-5599
Fax
(928) 443-5376
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6410 AZ Primary

Addresses

Primary practice location

7875 E Florentine Rd Ste a
Prescott Valley, AZ 86314-2284

Mailing address

7875 E Florentine Rd Ste a
Prescott Valley, AZ 86314-2284
Phone (928) 443-5599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210511001212 NY Practitioner - Physician Assistant 6204245830 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6410AZMDPhysical Therapist
025780NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Feb 9, 2021 Accepting new patients
Saratoga Hospital CurrentSince Feb 9, 2021 Accepting new patients
Oak Orchard Community Health Center Inc. CurrentSince Oct 17, 2021 Accepting new patients
Oak Orchard Community Health Center Inc CurrentSince Oct 17, 2021 Accepting new patients
Cornerstone Pediatrics, P.C. Past Accepting new patients

Locations

300 West Ave
Brockport, NY 14420
Phone (585) 637-3905

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

Organizations & group practices 7

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1588016356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7875 E FLORENTINE RD STE A",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142284",
            "telephone_number": "928-443-5599",
            "fax_number": "928-443-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 E FLORENTINE RD STE A",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142284",
            "telephone_number": "928-443-5599",
            "fax_number": "928-443-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.