Active NPI
Mildred N Rogers, B.S.
- Community/Behavioral Health Agency
- Durham, NC
National Provider Identifier
1801464300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 1659513786
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2239 | VA | MD | Peer Specialist |
| 1659513786 | NC | MD | Community/Behavioral Health Agency |
| 3399 | VA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Solutions and Support Services | Community/Behavioral Health | Current | 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.
-
- Community/Behavioral Health Agency
- Durham, NC
- NPI 1659513786
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.