Rose B. Shaffer, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

TP004716P Issued in PA

Practice address

111 S 11TH St
Room 1900 Gibbon
Philadelphia, PA 19107-4824

Phone

(215) 955-8408

Fax

(215) 955-8966

NPI assigned

Apr 15, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1053585562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST RM 5480G",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-8408",
            "fax_number": "215-503-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "ROOM 1900 GIBBON",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-8408",
            "fax_number": "215-955-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ROSE",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "TP004716P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103144230",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gene W Shaffer, MD
• Jordan Carla Shaffer, PA-C
• Katherine Anne Shaffer, MD
• Lauren Rose Shaffer, MD
• Martina Shaffer, CRNA
• Badar Bin Bilal Shafi
• Michael Shafik, D.O.
• Neha Shafique, MD
• Leah Shafran Topaz, BPT
• Yevgeniy Shagas, D.P.M.

• Acute Care Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.

Verify at the official NPI Registry.