THEONITA DIANE RODGERS (NPI# 1790812527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790812527 |
| Entity Type | Individual |
| Full Name | THEONITA DIANE RODGERS |
| Other Name | THEONITA DIANE PETTUS |
| Practice Address |
6501 W 12th St Little Rock AR 72204-1511 |
| Mailing Address |
Po Box 251970 Little Rock AR 72225-1970 |
| Practice Telephone | 5016668686 |
| Mailing Telephone | 5016668686 |
| Mailing Fax Number | 5016606830 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
6501 W 12TH ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639204795 | Loi Ann Chambers | Social Worker | 6501 W 12th St, Little Rock, AR 72204-1511 | 2007-02-22 |
| 1043847312 | Shaneka Hamilton | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-25 |
| 1679100952 | Angela Roby | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-25 |
| 1467087460 | Patricia Shavers | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-10 |
| 1811522816 | Christa Slinker | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-10 |
| 1346875341 | Amanda Loggins | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-10 |
| 1184259186 | Vaquita Rodgers | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-10 |
| 1174158174 | Devin Hester | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-10 |
| 1841825569 | Ruby Rachel Damper | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-04 |
| 1477188092 | Chelsea Fagan | Case Manager/Care Coordinator | 6501 W 12th St, Little Rock, AR 72204-1511 | 2020-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388751 | Shara Susannah Vincent | Specialist/Technologist, Other | 27 Choctaw Trce, Cherokee Village, AR 72529-2702 | 2020-08-28 |
| 1295281590 | Faith Nichole Duncan | Specialist/Technologist, Other | 2105 Aggie Rd, Jonesboro, AR 72401 | 2016-08-28 |
| 1023346525 | Thomas J. Johnson | Specialist/Technologist, Other | 1311 Strozier Ct, Barling, AR 72923-2035 | 2009-11-23 |
| 1720129778 | Functional Testing Centers, Inc. | Specialist/Technologist, Other | 3120 S Hazel St, Suite B, Pine Bluff, AR 71603-5740 | 2007-02-11 |
| 1295195758 | Rebecca Riemer | Specialist/Technologist, Other | 2227 West Main Street, Suite 3, Jacksonville, AR 72076 | 2016-02-26 |
| 1881090983 | Jessie Battles | Specialist/Technologist, Other | 2227 W Main St Ste 3, Jacksonville, AR 72076-4251 | 2014-11-17 |
| 1295131399 | Misty Angelique Roetzel | Specialist/Technologist, Other | 2227 W Main St, Suite 3, Jacksonville, AR 72076-4207 | 2014-11-17 |
| 1407188998 | Melissa Kaye Mabe | Specialist/Technologist, Other | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2010-02-08 |
| 1396972550 | Danielle Woffard | Specialist/Technologist, Other | 2040 Fitzhugh St, Batesville, AR 72501-7409 | 2009-06-16 |
| 1801924147 | North Arkanas Electric Cooperative Inc | Specialist/Technologist, Other | 225 Main St, Salem, AR 72576-1000 | 2007-02-28 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.