Healthcare Provider Details

I. General information

NPI: 1053938712
Provider Name (Legal Business Name): JAMIE ROGERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WYNDHURST DR
LYNCHBURG VA
24502-2550
US

IV. Provider business mailing address

3300 RIVERMONT AVE
LYNCHBURG VA
24503-2030
US

V. Phone/Fax

Practice location:
  • Phone: 434-237-8160
  • Fax: 434-237-8161
Mailing address:
  • Phone: 434-200-5032
  • Fax: 434-200-1294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213638
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: