Individual provider Active NPI

Derek Michael Rose, DC

  • Chiropractor
  • Aurora, NE
National Provider Identifier
1063061406
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022 Issued in NE
Practice address
1405 7TH St
Aurora, NE 68818-1141
Phone
(402) 694-6900
Fax
(402) 694-6904
NPI assigned
Sep 9, 2019
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022 NE Primary

Addresses

Primary practice location

1405 7TH St
Aurora, NE 68818-1141

Mailing address

32440 Road Y
Sutton, NE 68979-3024
Phone (402) 604-0214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923002962 NE Practitioner - Chiropractic 1759611445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rose Chiropractic Center, P.C.Group PAC ID 9537268156, 2 clinicians

Practice addresses (Care Compare)

1405 7TH St
Aurora, NE 68818-1141
Phone (402) 694-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Chiropractic Center, P.C. Chiropractor CurrentSince Sep 12, 2019 Accepting new patients

Locations

1405 7th St
Aurora, NE 68818
Phone (402) 694-6900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1063061406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32440 ROAD Y",
            "city": "SUTTON",
            "state": "NE",
            "postal_code": "689793024",
            "telephone_number": "402-604-0214",
            "fax_number": "402-694-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 7TH ST",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688181141",
            "telephone_number": "402-694-6900",
            "fax_number": "402-694-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DEREK",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "2022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.