Individual provider Active NPI

Nyisha Sharda Rogers

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1891218970
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5600 Forest Oaks Dr Apt D
Raleigh, NC 27609-5051
Phone
(910) 335-1197
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

5600 Forest Oaks Dr Apt D
Raleigh, NC 27609-5051

Mailing address

5600 Forest Oaks Dr Apt D
Raleigh, NC 27609-5051
Phone (910) 335-1197

Other practice location 1

4000 Tuckaseegee Rd
Charlotte, NC 28208-2832
Phone (704) 523-5745

Other identifiers 1

IdentifierTypeStateIssuer
NAMedicaidNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Wellness Clinical Current Accepting new patients

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1891218970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 FOREST OAKS DR APT D",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095051",
            "telephone_number": "910-335-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 FOREST OAKS DR APT D",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095051",
            "telephone_number": "910-335-1197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Tuckaseegee Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282082832",
            "country_code": "US",
            "telephone_number": "704-523-5745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "NYISHA",
        "middle_name": "SHARDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.