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NPI Code Detail

MEDICARE: JOHN ROGERS

MEDICARE: JOHN ROGERS
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
1172V00000XCommunity Health WorkerNM

General Provider Information

NPI Number : 1952786899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ROGERS
Provider Business Mailing Address
First Line : 653 W ARRINGTON ST
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-8513
Country : US
Telephone Number : 505-564-3733
Fax Number :
Provider Business Practice Location Address
First Line : 653 W ARRINGTON ST
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-8513
Country : US
Telephone Number : 505-564-3733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2015
Last Update Date : 01/06/2026

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