Active NPI
Rollin Louis Brossman, LPN
- Licensed Practical Nurse
- Springfield, OH
National Provider Identifier
1083827141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN. 119618 IV
- Practice address
- 3375 Columbus Ave Apt D
Springfield, OH 45503-3246 - Phone
- (937) 360-2003
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN. 119618 IV | OH | Primary |
Addresses
Primary practice location
3375 Columbus Ave Apt D
Springfield, OH 45503-3246
Mailing address
3375 Columbus Ave Apt D
Springfield, OH 45503-3246
Phone (937) 360-2003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2705157 | Medicaid | OH |
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 |
|---|---|---|---|
| PN. 119618 IV | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1083827141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3375 COLUMBUS AVE APT D",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455033246",
"telephone_number": "937-360-2003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3375 COLUMBUS AVE APT D",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455033246",
"telephone_number": "937-360-2003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROSSMAN",
"first_name": "ROLLIN",
"middle_name": "LOUIS",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN. 119618 IV",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2705157",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.