Jeremy Daniel Ross

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

225012 Issued in TX

Practice address

11582 C St
Joint Base Lewis-McChord, WA 98433

Phone

(253) 966-7574

NPI assigned

Mar 29, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1093178006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 S PINE ST APT J134",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096444",
            "telephone_number": "253-353-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11582 C ST",
            "city": "JOINT BASE LEWIS-MCCHORD",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "253-966-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "225012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micol Rebecca Rohr, LMP
• Christopher Randall Rohrbough, M.D.
• Samantha Rongstad, RDN
• Cesar Jose Rosa, D.O.
• Callie Roseland
• Hunter Reed Roth, PHARMD
• Danny Ruano
• Casey Alexander Ruiz, LCSW
• Hillary Rumbarger, COTA/L
• Michael C Saenz, LPN

• Licensed Practical Nurse in Joint Base Lewis-McChord, WA
• Providers in Joint Base Lewis-McChord, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.