Individual provider Active NPI

Holly D. Rogers, APRN

  • Family Nurse Practitioner
  • Anderson, SC
National Provider Identifier
1750763405
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19519 Issued in SC
Practice address
800 N Fant St.
Anderson, SC 29621
Phone
(864) 512-1335
NPI assigned
Jun 18, 2015
Last updated
Oct 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19519 SC Primary
Emergency Clinical Nurse Specialist 364SE0003X 19519 SC

Addresses

Primary practice location

800 N Fant St.
Anderson, SC 29621

Mailing address

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1335

Other identifiers 3

IdentifierTypeStateIssuer
NPI #OtherSCTRICARE - AFFILIATION
003167486AMedicaidGA
NP3357MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924003368 SC Practitioner - Nurse Practitioner 5496063463 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Family Practice Anderson LLCGroup PAC ID 5698167385, 4 clinicians

Practice addresses (Care Compare)

4144 Clemson Blvd
Anderson, SC 29621-1108
Phone (864) 224-9598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19519SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ich ER Services, LLC CurrentSince Sep 1, 2018 Accepting new patients
Piedmont Pathology Associates PA Current Accepting new patients
Anmed Health CurrentSince Jul 1, 2015 Accepting new patients
Anmed Health CurrentSince Jul 1, 2015 Accepting new patients
Anmed Health Current Accepting new patients
Trinity Family Practice Anderson LLC CurrentSince Sep 8, 2025 Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients

Locations

4144 Clemson Blvd
Anderson, SC 29621
Phone (864) 224-3332

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

Organizations & group practices 7

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1750763405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST.",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29621",
            "telephone_number": "864-512-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "HOLLY",
        "middle_name": "D.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19519",
            "primary": true
        },
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "SC",
            "license": "19519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE - AFFILIATION",
            "identifier": "NPI #",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003167486A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3357",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.