Healthcare Provider Details

I. General information

NPI: 1619814290
Provider Name (Legal Business Name): ANNA RODGERS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JEFFERSON AVE RM 323
MEMPHIS TN
38105-4934
US

IV. Provider business mailing address

1060 SPENCE RD
HALLS TN
38040-5202
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-4900
  • Fax: 901-287-4901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4621
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: