Individual provider Active NPI

Elisabeth Deborah Rogers, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1700464906
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24618 Issued in SC
Practice address
525 Bailey Ave
Fort Worth, TX 76107-2125
Phone
(817) 348-8488
Fax
(817) 348-8448
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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 24618 SC Primary

Addresses

Primary practice location

525 Bailey Ave
Fort Worth, TX 76107-2125

Mailing address

525 Bailey Ave
Fort Worth, TX 76107-2125
Phone (817) 348-8488

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
24618SCMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: elisabeth.rogers@4097.securemail.prognocis.com

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1700464906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 BAILEY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072125",
            "telephone_number": "817-348-8488",
            "fax_number": "817-348-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BAILEY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072125",
            "telephone_number": "817-348-8488",
            "fax_number": "817-348-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ELISABETH",
        "middle_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.