Individual provider Active NPI

Johnny Christopher Rogers

  • Clinical Social Worker
  • Pembroke, NC
National Provider Identifier
1639655095
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P012265
Practice address
30 Drakes Branch Dr
Pembroke, NC 28372-7325
Phone
(910) 521-0092
NPI assigned
Jul 18, 2018
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P012265 Primary

Addresses

Primary practice location

30 Drakes Branch Dr
Pembroke, NC 28372-7325

Mailing address

320 Paxton Loop
Red Springs, NC 28377-9464
Phone (910) 843-4319

Other practice location 1

2105 E Elizabethtown Rd
Lumberton, NC 28358-3107
Phone (910) 738-7865

Other practice location 2

2200 Clyborn Church Rd
Lumberton, NC 28360-9356
Phone (910) 739-9160

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lumberton Treatment Center LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1639655095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PAXTON LOOP",
            "city": "RED SPRINGS",
            "state": "NC",
            "postal_code": "283779464",
            "telephone_number": "910-843-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DRAKES BRANCH DR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727325",
            "telephone_number": "910-521-0092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2105 E Elizabethtown Rd",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283583107",
            "country_code": "US",
            "telephone_number": "910-738-7865",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Clyborn Church Rd",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283609356",
            "country_code": "US",
            "telephone_number": "910-739-9160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JOHNNY",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "P012265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.