Provider Demographics
NPI:1245280866
Name:ROGERS, APRIL T (PAC)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:T
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 W WESMARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1900
Mailing Address - Country:US
Mailing Address - Phone:803-905-6944
Mailing Address - Fax:803-469-3944
Practice Address - Street 1:641 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1900
Practice Address - Country:US
Practice Address - Phone:803-905-6944
Practice Address - Fax:803-469-3944
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA670IM363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP379725684OtherMEDICARE PTAN
SCC30400OtherRAILROAD MEDICARE
SC0052PAMedicaid
SC0052PAMedicaid
SC9827Medicare PIN