Individual provider Active NPI

Rose Marie Flinchum, CNS, RN

  • Adult Health Clinical Nurse Specialist
  • La Porte, IN
National Provider Identifier
1093121063
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
NOT REQUIRED IN IN Issued in IN
Practice address
1300 State St
Suite 1a
La Porte, IN 46350-3185
Phone
(219) 326-1234
Fax
(219) 325-7682
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X NOT REQUIRED IN IN IN Primary
Registered Nurse 163W00000X 28069463A IN
Registered Nurse 163W00000X 041278685 IL
Diabetes Educator Registered Nurse 163WD0400X CDE 0942-0223 IN

Addresses

Primary practice location

1300 State St
Suite 1a
La Porte, IN 46350-3185

Mailing address

1300 State St
Suite 1a
La Porte, IN 46350-3185
Phone (219) 326-1234

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
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041278685ILMDRegistered Nurse
28069463AINMDRegistered Nurse
CDE 0942-0223INMDDiabetes Educator Registered Nurse
NOT REQUIRED IN ININMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Chest Clinic, PC Past Accepting new patients

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1093121063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 STATE ST",
            "address_2": "SUITE 1A",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503185",
            "telephone_number": "219-326-1234",
            "fax_number": "219-325-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 STATE ST",
            "address_2": "SUITE 1A",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503185",
            "telephone_number": "219-326-1234",
            "fax_number": "219-325-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLINCHUM",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "CNS, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IN",
            "license": "NOT REQUIRED IN IN",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28069463A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041278685",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "IN",
            "license": "CDE 0942-0223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.