C Van Rosen PHD PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

C VAN ROSEN PHD PC

Practice address

28980 Hwy 98
Suite 1
Daphne, AL 36526-7283

Phone

(251) 621-2990

Fax

(251) 621-2921

NPI assigned

Apr 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. C Van Rosen, PHD

Title

President

Phone

(251) 621-2990

Specialties & licenses 9

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1043485543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28980 HWY 98",
            "address_2": "SUITE 1",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267283",
            "telephone_number": "251-621-2990",
            "fax_number": "251-621-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28980 HWY 98",
            "address_2": "SUITE 1",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267283",
            "telephone_number": "251-621-2990",
            "fax_number": "251-621-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C VAN ROSEN PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-621-2990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000070686",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51506934",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.