Individual provider Active NPI

Jordan Nicole Rogers, DNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1932097615
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
221112 Issued in AR
Practice address
1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356
Phone
(870) 243-0424
Fax
(534) 248-4225
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 221112 AR Primary

Addresses

Primary practice location

1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356

Mailing address

1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356
Phone (870) 243-0424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20250722001217 AR Practitioner - Nurse Practitioner 2365958832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Mental Health and Wellness LLCGroup PAC ID 0345574737, 24 clinicians

Practice addresses (Care Compare)

1150 E Matthews Ave
Suite 101a
Jonesboro, AR 72401-4356
Phone (870) 243-0424

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Mental Health and Wellness LLC Psychiatric/Mental Health CurrentSince Jun 24, 2025 Accepting new patients
Renew Mental Health and Wellness, LLC CurrentSince Jun 24, 2025 Accepting new patients

Locations

1150 E Matthews Ave
Ste 101A
Jonesboro, AR 72401
Phone (870) 243-0424

Organizations & group practices 2

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1932097615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424",
            "fax_number": "534-248-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424",
            "fax_number": "534-248-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "DNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "221112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.