Individual provider Active NPI

Mildred N Rogers, B.S.

  • Community/Behavioral Health Agency
  • Durham, NC
National Provider Identifier
1801464300
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1659513786 Issued in NC
Practice address
4324 S Alston Ave Ste 205
Durham, NC 27713-2567
Phone
(919) 748-4555
Fax
(919) 666-6854
NPI assigned
Jun 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 1659513786 NC
Peer Specialist 175T00000X 2239 VA
Community/Behavioral Health Agency 251S00000X 3399 VA
Community/Behavioral Health Agency 251S00000X 1659513786 NC Primary

Addresses

Primary practice location

4324 S Alston Ave Ste 205
Durham, NC 27713-2567

Mailing address

4324 S Alston Ave Ste 205
Durham, NC 27713-2567
Phone (919) 748-4555

Other practice location 1

300 Ringgold Industrial Pkwy Ste 105
Danville, VA 24540-5548
Phone (434) 770-8881

Other practice location 2

301 S Church St Ste 162
Rocky Mount, NC 27804-5748
Phone (252) 442-1577

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)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2239VAMDPeer Specialist
1659513786NCMDCommunity/Behavioral Health Agency
3399VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Solutions and Support Services Community/Behavioral Health CurrentSince Feb 11, 2024 Accepting new patients

Locations

4324 S Alston Ave
Ste 205
Durham, NC 27713
Phone (919) 748-4555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1801464300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 S ALSTON AVE STE 205",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277132567",
            "telephone_number": "919-748-4555",
            "fax_number": "919-666-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 S ALSTON AVE STE 205",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277132567",
            "telephone_number": "919-748-4555",
            "fax_number": "919-666-6854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Ringgold Industrial Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245405548",
            "country_code": "US",
            "telephone_number": "434-770-8881",
            "fax_number": "919-666-6854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 S Church St Ste 162",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278045748",
            "country_code": "US",
            "telephone_number": "252-442-1577",
            "fax_number": "919-237-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MILDRED",
        "middle_name": "N",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-12",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "1659513786",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "VA",
            "license": "2239",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "3399",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "1659513786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.