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NPI Code Detail

MEDICARE: JANEL A. ROGERS PSYD

MEDICARE: JANEL A. ROGERS PSYD
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
1103T00000XPsychologist20040322AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00293052OTHERINRAILROAD MEDICARE
5P00478525OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000203700OTHERINANTHEM
3000000543925OTHERINANTHEM
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
61771OTHERINPHYSICIANS HEALTH PLAN

General Provider Information

NPI Number : 1639158413
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANEL A. ROGERS PSYD
Provider Business Mailing Address
First Line : 1720 BEACON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4749
Country : US
Telephone Number : 260-373-8000
Fax Number : 260-373-8034
Provider Business Practice Location Address
First Line : 1720 BEACON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4749
Country : US
Telephone Number : 260-373-8000
Fax Number : 260-373-8034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 07/28/2008

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Directions to “ JANEL A. ROGERS PSYD” Practice Location

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