Individual provider Active NPI

Milda Harriet Rogers, CFNP

  • Family Nurse Practitioner
  • Prescott Valley, AZ
National Provider Identifier
1619952413
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP0372 Issued in AZ
Practice address
3221 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone
(928) 910-7010
Fax
(928) 910-7011
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP0372 AZ Primary

Addresses

Primary practice location

3221 N Windsong Dr
Prescott Valley, AZ 86314-1222

Mailing address

3221 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone (928) 910-7010

Other practice location 1

3633 Crossings Dr
Prescott, AZ 86305-3593
Phone (928) 778-0330

Other identifiers 2

IdentifierTypeStateIssuer
RN084978OtherAZLICENSE
432039MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP0372AZMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mrogers@intmed.gwaydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619952413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141222",
            "telephone_number": "928-910-7010",
            "fax_number": "928-910-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141222",
            "telephone_number": "928-910-7010",
            "fax_number": "928-910-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3633 Crossings Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863053593",
            "country_code": "US",
            "telephone_number": "928-778-0330",
            "fax_number": "928-778-1146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MILDA",
        "middle_name": "HARRIET",
        "name_prefix": "Ms.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN084978",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432039",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.