NPIMap

Individual provider Active NPI

Tara Nicole Rogers, P.A.

  • Surgical Physician Assistant
  • Conway, AR
National Provider Identifier
1831409135
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-513 Issued in AR
Practice address
505 E Dave Ward Dr
Conway, AR 72032-7825
Phone
(501) 500-3500
Fax
(501) 904-3620
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Surgical Physician Assistant 363AS0400X PA-513 AR Primary

Addresses

Primary practice location

505 E Dave Ward Dr
Conway, AR 72032-7825

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 404-8007

Other identifiers 1

IdentifierTypeStateIssuer
PA513OtherARLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000742 AR Practitioner - Physician Assistant 5597952234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 978-2623

Hospital & facility affiliations

  • Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154
  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1891TNMDBehavioral Analyst
PA-513ARMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoarkansas, PA CurrentSince Dec 27, 2024 Accepting new patients
Orthoarkansas, PA CurrentSince Dec 27, 2024 Accepting new patients
CC Bpci PLC Past Accepting new patients
Campbell Clinic, PC Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

505 E Dave Ward Dr
Conway, AR 72032
Phone (501) 327-4709

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

Interoperability endpoints

  • Direct secure messaging: tara.rogers.1@1376.direct.athenahealth.com
  • Direct secure messaging: tara.rogers@1246.chartlogic.direct-ci.com

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 7

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": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1831409135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327825",
            "telephone_number": "501-500-3500",
            "fax_number": "501-904-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TARA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AR",
            "license": "PA-513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA513",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.