Individual provider Active NPI

Jennifer Nicole Rogers, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Charleston, AR
National Provider Identifier
1609573203
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
223441 Issued in AR
Practice address
107 S Logan St
Charleston, AR 72933-9036
Phone
(479) 573-3120
Fax
(479) 965-2008
NPI assigned
Feb 14, 2023
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 223441 AR Primary

Addresses

Primary practice location

107 S Logan St
Charleston, AR 72933-9036

Mailing address

107 S Logan St
Charleston, AR 72933-9036
Phone (479) 573-3120

Other identifiers 2

IdentifierTypeStateIssuer
223441OtherARAPRN-CNP
F01230570OtherARAANP CERTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230331000847 AR Practitioner - Nurse Practitioner 8527433754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

107 S Logan St
Charleston, AR 72933-9036
Phone (479) 573-3120

3501 We Knight Dr
Fort Smith, AR 72903-6254
Phone (479) 709-6700

6801 Rogers Ave
FL 3
Fort Smith, AR 72903-4067
Phone (479) 573-3042

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223441ARMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 20, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 20, 2023 Accepting new patients

Locations

107 S Logan St
Charleston, AR 72933
Phone (479) 573-3120

3501 We Knight Dr
Fort Smith, AR 72903
Phone (479) 709-6700

3700 Cliff Dr
Fort Smith, AR 72903
Phone (479) 259-9286

6801 Rogers Ave
Fl 3
Fort Smith, AR 72903
Phone (479) 274-4000

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Organizations & group practices 4

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 1

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": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1609573203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S LOGAN ST",
            "city": "CHARLESTON",
            "state": "AR",
            "postal_code": "729339036",
            "telephone_number": "479-573-3120",
            "fax_number": "479-965-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S LOGAN ST",
            "city": "CHARLESTON",
            "state": "AR",
            "postal_code": "729339036",
            "telephone_number": "479-573-3120",
            "fax_number": "479-965-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "223441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN-CNP",
            "identifier": "223441",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION NUMBER",
            "identifier": "F01230570",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, AR

Sources for this page

Verify at the official NPI Registry.