Individual provider Active NPI

James S Rogers Jr., LCSW

  • Clinical Social Worker
  • Amarillo, TX
National Provider Identifier
1710979414
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10387 Issued in TX
Practice address
1616 S Kentucky St
Suite 125a
Amarillo, TX 79102-2250
Phone
(806) 463-7001
Fax
(806) 463-7006
NPI assigned
Aug 18, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6087 TX
Clinical Social Worker 1041C0700X 10387 TX Primary

Addresses

Primary practice location

1616 S Kentucky St
Suite 125a
Amarillo, TX 79102-2250

Mailing address

1616 S Kentucky St
Suite 125a
Amarillo, TX 79102-2252
Phone (806) 463-7001

Other identifiers 2

IdentifierTypeStateIssuer
00S68KOtherTXBC/BS OF TEXAS
1082463-02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041006001153 TX Practitioner - Clinical Social Worker 8426017328 Practice locations: Amarillo, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Washington University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2505 Lakeview Dr
Suite 205
Amarillo, TX 79109-1523
Phone (806) 463-7001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6087TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1710979414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S KENTUCKY ST",
            "address_2": "SUITE 125A",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791022252",
            "telephone_number": "806-463-7001",
            "fax_number": "806-463-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S KENTUCKY ST",
            "address_2": "SUITE 125A",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791022250",
            "telephone_number": "806-463-7001",
            "fax_number": "806-463-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "6087",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "10387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "00S68K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1082463-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.