Jennifer Rose, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

37001996A Issued in IN

Practice address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Phone

(260) 426-5431

NPI assigned

Jan 15, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1063052264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 MILLENNIUM XING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1606 Millennium Xing",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468459198",
            "country_code": "US",
            "telephone_number": "260-341-6417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JENNIFER",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37001996A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Rosales, OTD, OTR/ L
• Jerome Alegado Rosales, P.T.
• Khiara Rosales
• Ibijoke F Rosanwo
• Faith Marie Rose
• Karrie Ann Rose, RPH
• Sashelle P Rose, M.S.ED., LMHCA
• Andrea Rosen, RN
• Michael Rosen
• David Rosenbeck

• Registered Dietitian in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.