Individual provider Active NPI

Gary Allan Roseman, R.PH.

  • Pharmacist
  • Urbandale, IA
National Provider Identifier
1033285895
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
IA-15548 Issued in IA
Practice address
3998 NW Urbandale Dr
Urbandale, IA 50322-7922
Phone
(515) 278-0117
Fax
(515) 278-6165
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IA-15548 IA Primary

Addresses

Primary practice location

3998 NW Urbandale Dr
Urbandale, IA 50322-7922

Mailing address

PO Box 42311
Urbandale, IA 50323-0985
Phone (515) 727-5689

Other identifiers 1

IdentifierTypeStateIssuer
0298463MedicaidIA

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
IA-15548IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hy-Vee Inc Past Accepting new patients
Hy-Vee Care Past Accepting new patients

Organizations & group practices 2

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033285895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42311",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503230985",
            "telephone_number": "515-727-5689",
            "fax_number": "515-727-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 NW URBANDALE DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503227922",
            "telephone_number": "515-278-0117",
            "fax_number": "515-278-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMAN",
        "first_name": "GARY",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "IA-15548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.