Individual provider Active NPI

Jessica Lyn Rogers, PHARMD

  • Emergency Medicine Pharmacist
  • Beavercreek, OH
National Provider Identifier
1881361301
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PharmacistTaxonomy code 1835E0208X
License
03442038 Issued in OH
Practice address
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone
(937) 702-4000
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61185934 WA
Emergency Medicine Pharmacist 1835E0208X 03442038 OH Primary
Pharmacist 183500000X 23702 CO

Addresses

Primary practice location

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

Mailing address

4140 Brookdale LN Unit 10
Dayton, OH 45440-3997
Phone (303) 242-2716

Other practice location 1

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
23702COMDPharmacist
PH61185934WAMDPharmacist
03442038OHMDMedical license number

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1881361301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 BROOKDALE LN UNIT 10",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403997",
            "telephone_number": "303-242-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-702-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-946-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61185934",
            "primary": false
        },
        {
            "code": "1835E0208X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Emergency Medicine",
            "state": "OH",
            "license": "03442038",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "23702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.