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NPI Code Detail

MEDICARE: JAIDELYNN ROGERS PHD

MEDICARE: JAIDELYNN ROGERS PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2026005464MO
2103T00000XPsychologist13403136-2501UT

General Provider Information

NPI Number : 1336924414
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIDELYNN ROGERS PHD
Provider Business Mailing Address
First Line : 1800 COMMUNITY
Second Line :
City : CLINTON
State : MO
Zip : 64735-8804
Country : US
Telephone Number : 844-853-8937
Fax Number :
Provider Business Practice Location Address
First Line : 1032 CROSSWINDS CT
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-4836
Country : US
Telephone Number : 844-853-8937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 02/06/2026

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