Active NPI
Beth Rogers, CNP
- Family Nurse Practitioner
- Manteno, IL
National Provider Identifier
1922058726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Practice address
- 1 Veterans Dr
Manteno, IL 60950-9466 - Phone
- (815) 468-1027
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | IL | Primary |
Addresses
Primary practice location
1 Veterans Dr
Manteno, IL 60950-9466
Mailing address
701 S Chestnut St
Wenona, IL 61377
Phone (815) 853-4688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00067912 | Other | IL | RAILROAD MEDICARE |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209004445 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922058726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 S CHESTNUT ST",
"city": "WENONA",
"state": "IL",
"postal_code": "61377",
"telephone_number": "815-853-4688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VETERANS DR",
"city": "MANTENO",
"state": "IL",
"postal_code": "609509466",
"telephone_number": "815-468-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "BETH",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00067912",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manteno, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.