Individual provider Active NPI

Lynne Ann Rodger, RN BSN

  • Registered Nurse
  • Rankon Koma, NY
National Provider Identifier
1891933396
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
44-7934 Issued in NY
Practice address
84 West 1St Street
Rankon Koma, NY 11779
Phone
(631) 467-7550
NPI assigned
Jan 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 44-7934 NY Primary

Addresses

Primary practice location

84 West 1St Street
Rankon Koma, NY 11779

Mailing address

84 West 1St Street
Rankon Koma, NY 11779

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 on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
44-7934NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1891933396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 WEST 1ST STREET",
            "city": "RANKON KOMA",
            "state": "NY",
            "postal_code": "11779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 WEST 1ST STREET",
            "city": "RANKON KOMA",
            "state": "NY",
            "postal_code": "11779",
            "telephone_number": "631-467-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGER",
        "first_name": "LYNNE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "44-7934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.