Active NPI
Alice T Rose, PH.D.
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1043510167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0000983
- Practice address
- 520 Emory Cir NE
Atlanta, GA 30307-1145 - Phone
- (678) 886-8680
- NPI assigned
- Oct 22, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0000983 | GA | Primary |
Addresses
Primary practice location
520 Emory Cir NE
Atlanta, GA 30307-1145
Mailing address
520 Emory Cir NE
Atlanta, GA 30307-1145
Phone (678) 886-8680
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: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000983 | GA | MD | Clinical Psychologist |
| 983 | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1043510167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 EMORY CIR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303071145",
"telephone_number": "678-886-8680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 EMORY CIR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303071145",
"telephone_number": "678-886-8680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ALICE",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "0000983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.