Individual provider Active NPI

Jenna Macgillivray Rogerson, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1689186900
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18064 Issued in FL
Practice address
10129 Clear Vista St
Orlando, FL 32832-7164
Phone
(833) 663-6331
NPI assigned
Oct 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X SW18064 FL Primary

Addresses

Primary practice location

10129 Clear Vista St
Orlando, FL 32832-7164

Mailing address

740 Java Rd
Cocoa Beach, FL 32931-3075
Phone (407) 761-4737

Other practice location 1

2479 Aloma Ave
Winter Park, FL 32792-2541
Phone (407) 657-6692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230414002013 FL Practitioner - Clinical Social Worker 1355716846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

10129 Clear Vista St
Orlando, FL 32832-7164
Phone (770) 312-5226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW18064FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 26, 2025 Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

10129 Clear Vista St
Orlando, FL 32832
Phone (407) 601-1370

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jenna.rogerson.1@17832.direct.athenahealth.com

Organizations & group practices 2

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": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1689186900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 JAVA RD",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313075",
            "telephone_number": "407-761-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10129 CLEAR VISTA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328327164",
            "telephone_number": "833-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2479 Aloma Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327922541",
            "country_code": "US",
            "telephone_number": "407-657-6692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERSON",
        "first_name": "JENNA",
        "middle_name": "MACGILLIVRAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.