Provider Demographics
NPI:1588195515
Name:ROGERS, JOHN CHARLES (APN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:ROGERS
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2102
Mailing Address - Country:US
Mailing Address - Phone:423-209-8000
Mailing Address - Fax:
Practice Address - Street 1:730 E 11TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3103
Practice Address - Country:US
Practice Address - Phone:423-209-5800
Practice Address - Fax:423-498-4587
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN266135363LF0000X, 363LA2100X
TNAPN0000022262363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care