Individual provider Active NPI

Colleen Rogers

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1972925477
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008437 Issued in VA
Practice address
607 Schley Ave
Frederick, MD 21702-4157
Phone
(703) 655-9005
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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 0904008437 VA Primary

Addresses

Primary practice location

607 Schley Ave
Frederick, MD 21702-4157

Mailing address

607 Schley Ave
Frederick, MD 21702-4157
Phone (703) 655-9005

Other identifiers 2

IdentifierTypeStateIssuer
0904008437OtherVAVIRGINIA DEPARTMENT OF HEALTH
24253OtherMDMARYLAND BOARD OF SOCIAL WORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008437VAMDClinical Social Worker
24253MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1972925477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 SCHLEY AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024157",
            "telephone_number": "703-655-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 SCHLEY AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024157",
            "telephone_number": "703-655-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF HEALTH",
            "identifier": "0904008437",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF SOCIAL WORK",
            "identifier": "24253",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.