Healthcare Provider Details

I. General information

NPI: 1295671691
Provider Name (Legal Business Name): ROGERS MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 HIGHWAY 57 W
GRAND JUNCTION TN
38039-4447
US

IV. Provider business mailing address

1603 CAPITOL AVE STE 415 #443913
CHEYENNE WY
82001
US

V. Phone/Fax

Practice location:
  • Phone: 866-323-4660
  • Fax: 307-204-7207
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: WHITLEY ROGERS
Title or Position: ORGANIZER
Credential: NP
Phone: 662-231-2243