Individual provider Active NPI

Kali Dempsey Rogers, FNP

  • Family Nurse Practitioner
  • Louisville, MS
National Provider Identifier
1902379795
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902926 Issued in MS
Practice address
16569 W Main St
Louisville, MS 39339-2647
Phone
(662) 773-5704
Fax
(662) 773-9463
NPI assigned
Jan 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 892072 MS
Family Nurse Practitioner 363LF0000X 902926 MS Primary

Addresses

Primary practice location

16569 W Main St
Louisville, MS 39339-2647

Mailing address

PO Box 127
Louisville, MS 39339-0127
Phone (662) 803-7206

Other practice location 1

1207 Highway 182 W
Starkville, MS 39759-9013
Phone (662) 320-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424000318 MS Practitioner - Nurse Practitioner 2769724723 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
892072MSMDRegistered Nurse
902926MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winston Medical Clinic LLC CurrentSince Apr 19, 2019 Accepting new patients
Ard Medical Clinic PLLC Current Accepting new patients
Winston Medical Clinic LLC Current Accepting new patients
Winston Medical Clinic LLC CurrentSince Apr 19, 2019 Accepting new patients
Medplus Urgent Clinic LLC Family PastSince Jan 3, 2019 Accepting new patients

Locations

16569 W Main St
Louisville, MS 39339
Phone (662) 773-5704

177 N Columbus Ave
Louisville, MS 39339

Interoperability endpoints

  • Direct secure messaging: kali.rogers.1@15070.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJABD

Organizations & group practices 5

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": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1902379795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393390127",
            "telephone_number": "662-803-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16569 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392647",
            "telephone_number": "662-773-5704",
            "fax_number": "662-773-9463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Highway 182 W",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397599013",
            "country_code": "US",
            "telephone_number": "662-320-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KALI",
        "middle_name": "DEMPSEY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "892072",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, MS

Sources for this page

Verify at the official NPI Registry.