Individual provider Active NPI

Jamison Eugene Rogers, M.D.

  • Child & Adolescent Psychiatry Physician
  • East Providence, RI
National Provider Identifier
1790906089
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD12357 Issued in RI
Practice address
1011 Veterans Memorial Parkway
East Providence, RI 02915-5061
Phone
(401) 432-1000
Fax
(401) 432-1509
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD12357 RI
Child & Adolescent Psychiatry Physician 2084P0804X MD12357 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Parkway
East Providence, RI 02915-5061

Mailing address

1011 Veterans Memorial Parkway
East Providence, RI 02915-5061
Phone (401) 432-1284

Other identifiers 1

IdentifierTypeStateIssuer
MD12357OtherRIRHODE ISLAND MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090904000119 RI Practitioner - Psychiatry 6709931256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of South Florida College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

1 Hoppin St
Suite 204
Providence, RI 02903-4141
Phone (401) 444-8945

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emma Pendleton Bradley Hospital Psychiatry CurrentSince Jun 29, 2011 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Emma Pendleton Bradley Hospital Current Accepting new patients
Lifespan Physician Group, Inc. Psychiatry Current Accepting new patients

Locations

593 Eddy St
Providence, RI 02903

593 Eddy St
Rm 38
Providence, RI 02903
Phone (401) 444-4779

1 Hoppin St
Ste 204
Providence, RI 02903
Phone (401) 444-8945

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Organizations & group practices 4

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.

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1790906089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PARKWAY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1284",
            "fax_number": "401-432-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PARKWAY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JAMISON",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD12357",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD12357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHODE ISLAND MEDICAL LICENSE",
            "identifier": "MD12357",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.