Healthcare Provider Details

I. General information

NPI: 1205337961
Provider Name (Legal Business Name): ROGERS MEMORIAL HOSPITAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 W KENNEDY BLVD STE 600
TAMPA FL
33609-1820
US

IV. Provider business mailing address

34700 VALLEY RD
OCONOMOWOC WI
53066-4500
US

V. Phone/Fax

Practice location:
  • Phone: 800-767-4411
  • Fax:
Mailing address:
  • Phone: 800-767-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CINDY MEYER
Title or Position: PRESIDENT & CEO
Credential: MSSW
Phone: 262-303-0580