Individual provider Active NPI

Pamela Jane Rogers, M.D.

  • Pediatrics Physician
  • Newburgh, IN
National Provider Identifier
1891760419
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01061308A Issued in IN
Practice address
4111 Gateway Blvd
Newburgh, IN 47630-8954
Phone
(812) 853-5300
Fax
(812) 858-4660
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01061308A IN Primary

Addresses

Primary practice location

4111 Gateway Blvd
Newburgh, IN 47630-8954

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 853-5300

Other identifiers 2

IdentifierTypeStateIssuer
200825360MedicaidIN
000000392427OtherINBCBS PIN

Other names 1

  • Pamela Jane Miller Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000392 IN Practitioner - Pediatric Medicine 8527067131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01061308AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Pediatrics CurrentSince May 31, 2016 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic Inc Pediatrics CurrentSince May 31, 2016 Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4111 Gateway Blvd
Newburgh, IN 47630
Phone (812) 853-5300

4133 Gateway Blvd
Ste 290
Newburgh, IN 47630
Phone (812) 842-2701

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: progers2488@direct.deaconess.com

Organizations & group practices 3

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1891760419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308954",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "PAMELA",
        "middle_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01061308A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200825360",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "000000392427",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "MILLER",
            "middle_name": "JANE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.