Individual provider Active NPI

Mark H Rogan, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1902069362
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW4366 Issued in TN
Practice address
1027 S Yates Rd
Memphis, TN 38119-3707
Phone
(901) 682-6136
Fax
(901) 682-7136
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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 LSW4366 TN Primary

Addresses

Primary practice location

1027 S Yates Rd
Memphis, TN 38119-3707

Mailing address

1027 S Yates Rd
Memphis, TN 38119-3707
Phone (901) 682-6136

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

State licenses

LicenseStateTypeSpecialty
LSW4366TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1902069362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 S YATES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193707",
            "telephone_number": "901-682-6136",
            "fax_number": "901-682-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 S YATES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193707",
            "telephone_number": "901-682-6136",
            "fax_number": "901-682-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGAN",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW4366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.