Craig Douglas Rouben

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007663 Issued in KY

Practice address

110 Chase Way Ste 2
Elizabethtown, KY 42701-7827

Phone

(502) 212-0071

NPI assigned

Oct 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialistsmat PSCGroup PAC ID 7810307634, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Specialistsmat PSC

  • Addiction Medicine (Anesthesiology) Physician
  • Elizabethtown, KY
  • NPI 1851998181
  Medicare reassignment Care Compare group NPD
• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711
  Medicare reassignment

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1043562267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MARKET ST",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119535",
            "telephone_number": "812-246-9809",
            "fax_number": "770-573-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHASE WAY STE 2",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017827",
            "telephone_number": "502-212-0071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471306016",
            "country_code": "US",
            "telephone_number": "812-288-2488",
            "fax_number": "770-573-9513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 Dowell Rd",
            "address_purpose": "LOCATION",
            "city": "Russell Springs",
            "state": "KY",
            "postal_code": "426424278",
            "country_code": "US",
            "telephone_number": "270-866-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUBEN",
        "first_name": "CRAIG",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1087566",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "71004539A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IN",
            "identifier": "IN3604006",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201212500",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tony G. Rose, NCC, LPCC
• Rosenwald Life Center
• Rosenwald Life Center
• Shelby Roshoe, INTERN
• Carolyn M Ross
• Scott Rouse, MAT, MASE, ATC
• Sophie Camille Routt
• Amy Routte, LCSW
• Jessica Nicole Routte
• Elouise Malisa Rowden, MENTAL HEALTH ASSOC

• Family Nurse Practitioner in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.