Active NPI
John M Brose
- Case Manager/Care Coordinator
- Irwin, PA
National Provider Identifier
1073835807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 00000060
- Practice address
- 1012 Cicero Dr
Irwin, PA 15642-6517 - Phone
- (724) 610-1583
- Fax
- (724) 863-1256
- NPI assigned
- Feb 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 00000060 | WV | Primary |
Addresses
Primary practice location
1012 Cicero Dr
Irwin, PA 15642-6517
Mailing address
1012 Cicero Dr
Irwin, PA 15642-6517
Phone (724) 610-1583
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000060 | Other | WV | QRP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000060 | WV | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266710400000",
"number": "1073835807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 CICERO DR",
"city": "IRWIN",
"state": "PA",
"postal_code": "156426517",
"telephone_number": "724-610-1583",
"fax_number": "724-863-1256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 CICERO DR",
"city": "IRWIN",
"state": "PA",
"postal_code": "156426517",
"telephone_number": "724-610-1583",
"fax_number": "724-863-1256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROSE",
"first_name": "JOHN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-21",
"last_updated": "2010-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "WV",
"license": "00000060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QRP",
"identifier": "00000060",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irwin, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.