Active NPI
Phillip Jay Rosenbaum
- School Counselor
- Pontiac, MI
National Provider Identifier
1023313665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- Practice address
- 114 Orchard Lake Rd
Pontiac, MI 48341-2244 - Phone
- (248) 624-3812
- Fax
- (248) 624-0368
- NPI assigned
- Jan 12, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | Primary |
Addresses
Primary practice location
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Mailing address
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone (248) 624-3812
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1883825 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294790400000",
"number": "1023313665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412244",
"telephone_number": "248-624-3812",
"fax_number": "248-624-0368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412244",
"telephone_number": "248-624-3812",
"fax_number": "248-624-0368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBAUM",
"first_name": "PHILLIP",
"middle_name": "JAY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-12",
"last_updated": "2011-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1883825",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.