Keith Rose, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301064558 Issued in MI

Practice address

3916 Charlevoix Ave
Suite B
Petoskey, MI 49770-9722

Phone

(231) 348-1995

Fax

(231) 347-3223

NPI assigned

Aug 9, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northern Edge Institute of Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Petoskey, MI
  • NPI 1295745412
  NPD (past) Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1063422285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497700034",
            "telephone_number": "231-348-1995",
            "fax_number": "231-347-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 CHARLEVOIX AVE",
            "address_2": "SUITE B",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709722",
            "telephone_number": "231-348-1995",
            "fax_number": "231-347-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301064558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2502410522",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5176947",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4692460-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Elizabeth Rodgers-Biebuyck, D.O.
• Rodney Grambeau Family Dentistry
• Paul Eugene Romig, MD
• Ronald a Ronquist MD PC
• Ronald a Ronquist MD PC
• Dylan Rosenthal
• Ashley J Rossman, D.O.
• Shannon Marie Rossman, LBSW, CADC, CPRC
• Donald Bruce Roth, M.D.
• Rebecca Roth, PH.D.

• Physical Medicine & Rehabilitation Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.