Individual provider Active NPI

Mary J Rosenbauer, MS, RNC, CPNP, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Dayton, OH
National Provider Identifier
1104168418
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
RN205022 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1873
Phone
(937) 641-3000
Fax
(937) 641-5436
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X RN205022 OH Primary
Neonatal Intensive Care Registered Nurse 163WN0002X RN205022 OH

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1873

Mailing address

1 Childrens PLZ
Dayton, OH 45404-1873
Phone (937) 641-3000

Other names 1

  • Mari Jo Rosenbauer Other name

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 Pediatric Nurse Practitioner, Master of Science

State licenses

LicenseStateTypeSpecialty
RN205022OHMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1104168418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3000",
            "fax_number": "937-641-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3000",
            "fax_number": "937-641-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUER",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "MS, RNC, CPNP, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OH",
            "license": "RN205022",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "OH",
            "license": "RN205022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARI",
            "last_name": "ROSENBAUER",
            "middle_name": "JO",
            "credential": "MS, RNC, CPNP, IBCLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.