Individual provider Active NPI

Kimberly Rogoff, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Laurel, NJ
National Provider Identifier
1750435509
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NO07012500 Issued in NJ
Practice address
13 Sandhurst Dr
Mount Laurel, NJ 08054-6290
Phone
(609) 330-4214
NPI assigned
Jan 22, 2007
Last updated
Aug 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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 26NO07012500 NJ Primary

Addresses

Primary practice location

13 Sandhurst Dr
Mount Laurel, NJ 08054-6290

Mailing address

13 Sandhurst Dr
Mount Laurel, NJ 08054-6290
Phone (609) 330-4214

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

State licenses

LicenseStateTypeSpecialty
26NO07012500NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants, PC Past Accepting new patients
Virtua Medical Group, PA Nurse Anesthetist, Certified Registered PastSince Nov 15, 2020 Accepting new patients

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, 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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1750435509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SANDHURST DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546290",
            "telephone_number": "609-330-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 SANDHURST DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546290",
            "telephone_number": "609-330-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGOFF",
        "first_name": "KIMBERLY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NO07012500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.