Individual provider Active NPI

Robert K Rogers, CRNA

  • Certified Registered Nurse Anesthetist
  • Tupelo, MS
National Provider Identifier
1720005200
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R850408 Issued in MS
Practice address
830 South Gloster
Tupelo, MS 38801
Phone
(662) 377-4394
Fax
(662) 377-7045
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R850408 MS Primary

Addresses

Primary practice location

830 South Gloster
Tupelo, MS 38801

Mailing address

PO Box 3294
Tupelo, MS 38803-3294
Phone (662) 377-4394

Other identifiers 2

IdentifierTypeStateIssuer
07901531MedicaidMS
009936472MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040706000965 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264419456 Reassigns benefits to 7 organizations
I20220718000052 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264419456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians
Monroe Health Services IncGroup PAC ID 8224376561, 33 clinicians

Practice addresses (Care Compare)

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

1105 Earl Frye Blvd
Amory, MS 38821-5500

Hospital & facility affiliations

  • North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R850408MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clay County Medical Corporation CurrentSince Feb 1, 2022 Accepting new patients
Clay County Medical Corporation Current Accepting new patients
North Mississippi Medical Center CurrentSince Sep 27, 2004 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Tupelo Anesthesia Group PA CurrentSince Jan 29, 2010 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 27, 2004 Accepting new patients
Marion Regional Medical Center, Inc. Current Accepting new patients
DHS Anesthesia, LLC CurrentSince Sep 1, 2017 Accepting new patients
Clay County Medical Corporation CurrentSince Feb 1, 2022 Accepting new patients
Monroe Health Services, Inc. CurrentSince Apr 17, 2021 Accepting new patients
Marion Regional Medical Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 23, 2022 Accepting new patients
Marion Regional Medical Center, Inc CurrentSince May 23, 2022 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2019 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 22, 2020 Accepting new patients
Monroe Health Services, Inc. CurrentSince Apr 17, 2021 Accepting new patients
Eastern Panhandle Anesthesia Associates Past Accepting new patients

Locations

1336 Military St S
Hamilton, AL 35570
Phone (205) 921-0521

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

901 E Sunflower Rd
Cleveland, MS 38732
Phone (662) 846-0061

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

589 Garfield St
Tupelo, MS 38801
Phone (601) 680-5565

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Interoperability endpoints

  • Direct secure messaging: robertrogers@nmhs.medalliesdirect.net

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1720005200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3294",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033294",
            "telephone_number": "662-377-4394",
            "fax_number": "662-377-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SOUTH GLOSTER",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-377-4394",
            "fax_number": "662-377-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R850408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07901531",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936472",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.