Individual provider Active NPI

Rosemary Hynes Koul, MSN, CRNP, CPNP-AC

  • Critical Care Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1023683075
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
SP023755 Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone
(215) 590-1000
NPI assigned
May 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0222X SP023755 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104

Mailing address

4342 Park South Station Blvd
Charlotte, NC 28210-4481
Phone (540) 207-9443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP023755PAMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Multi-Specialty Current Accepting new patients
Carolinas Physicians Network Inc Multi-Specialty CurrentSince Sep 10, 2023 Accepting new patients
Carolinas Physicians Network Inc. Multi-Specialty CurrentSince Sep 10, 2023 Accepting new patients

Locations

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1023683075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 PARK SOUTH STATION BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104481",
            "telephone_number": "540-207-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUL",
        "first_name": "ROSEMARY",
        "middle_name": "HYNES",
        "credential": "MSN, CRNP, CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "PA",
            "license": "SP023755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.