The Rose Clinic for Plastic and Migraine Surgery

Primary specialty

SpecialistTaxonomy code 174400000X

License

5575028-1205 Issued in UT

Legal business name

THE ROSE CLINIC FOR PLASTIC AND MIGRAINE SURGERY

Practice address

320 River Park Dr
Suite 245
Provo, UT 84604-6060

Phone

(801) 375-7673

Fax

(801) 375-7679

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kevin G Rose, M.D.NPI 1245276021

Title

Doctor/Owner

Phone

(801) 375-7673

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin G Rose, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Springville, UT
  • NPI 1245276021
  NPD (past) Authorized official

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1093990210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR",
            "address_2": "SUITE245",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046060",
            "telephone_number": "801-375-7673",
            "fax_number": "801-375-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR",
            "address_2": "SUITE 245",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046060",
            "telephone_number": "801-375-7673",
            "fax_number": "801-375-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ROSE CLINIC FOR PLASTIC AND MIGRAINE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "801-375-7673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "5575028-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528431055001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim E Thayne
• The Body Hackers
• The Edify Group PLLC
• The Journey
• The Journey
• Evan Dale Theobald, PHARMACIST
• Therapy Inn, LLC
• Therapy Transformed - MWP
• Grace F Therber
• Theta Management Corporation

• Specialist in Provo, UT
• Providers in Provo, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.