Active NPI
Rosemary Hynes Koul, MSN, CRNP, CPNP-AC
- Critical Care Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1023683075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- SP023755
- 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
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 |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP023755 | PA | MD | Critical Care Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Multi-Specialty | Current | Accepting new patients |
| Carolinas Physicians Network Inc | Multi-Specialty | Current | Accepting new patients |
| Carolinas Physicians Network Inc. | Multi-Specialty | Current | 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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
Multi-Specialty
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charlotte, NC
- NPI 1477878890
Multi-Specialty
-
- Vascular Surgery Physician
- Charlotte, NC
- NPI 1881624807
Multi-Specialty
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.