Individual provider Active NPI

Eldean Rogers, RN

  • Registered Nurse
  • Jacksonville, AR
National Provider Identifier
1629190103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R44445 Issued in AR
Practice address
2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214
Phone
(501) 982-0528
Fax
(501) 985-7777
NPI assigned
Apr 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R44445 AR Primary

Addresses

Primary practice location

2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214

Mailing address

2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214
Phone (501) 982-0528

Other identifiers 1

IdentifierTypeStateIssuer
A083OtherARTRICARE NUMBER

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R44445ARMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629190103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 W MAIN ST",
            "address_2": "CO PATHFINDER INC",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764214",
            "telephone_number": "501-982-0528",
            "fax_number": "501-985-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 W MAIN ST",
            "address_2": "CO PATHFINDER INC",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764214",
            "telephone_number": "501-982-0528",
            "fax_number": "501-985-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ELDEAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R44445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NUMBER",
            "identifier": "A083",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.