NPIMap

Individual provider Active NPI

Colin A Rose, M.D.

  • Diagnostic Radiology Physician
  • Ronceverte, WV
National Provider Identifier
1104901347
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
17710 Issued in WV
Practice address
202 Maplewood Ave
Ronceverte, WV 24970-1334
Phone
(304) 645-4043
Fax
(304) 645-4713
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 17710 WV Primary

Addresses

Primary practice location

202 Maplewood Ave
Ronceverte, WV 24970-1334

Mailing address

PO Box 671
Lewisburg, WV 24901-0671
Phone (304) 645-4043

Other identifiers 8

IdentifierTypeStateIssuer
1058352OtherWVWV WORKERS COMP
0120309000MedicaidWV
010097983OtherWVFEDERAL WKRS COMP/BL
462502OtherANTHEM BCBS
55073865301OtherCHAMPUS
300126637OtherWVRAILROAD MCARE
001722063OtherWVMTN STATE BCBS
288546OtherWVMAMSI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080616000448 VA Practitioner - Diagnostic Radiology 0345311536 Practice locations: Low Moor, VA
I20081027000053 WV Practitioner - Diagnostic RadiologyPractitioner - Family Practice 0345311536 Reassigns benefits to 1 organization
Practice locations: Lewisburg, WV

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Family Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia Radiology Associates PCGroup PAC ID 9133666431, 91 clinicians

Practice addresses (Care Compare)

730 Jefferson St S
Lewisburg, WV 24901-2096
Phone (469) 757-1042

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Camc Greenbrier Valley Medical Center, Inc Hospital, Ronceverte, WV, CCN 510002
  • Camc Plateau Medical Center, Inc Hospital, Oak Hill, WV, CCN 511317
  • Boone Memorial Hospital Hospital, Madison, WV, CCN 511313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Radiology Associates PC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

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 and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1104901347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249010671",
            "telephone_number": "304-645-4043",
            "fax_number": "304-645-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701334",
            "telephone_number": "304-645-4043",
            "fax_number": "304-645-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "COLIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "17710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP",
            "identifier": "1058352",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120309000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WKRS COMP/BL",
            "identifier": "010097983",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "462502",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "55073865301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE",
            "identifier": "300126637",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MTN STATE BCBS",
            "identifier": "001722063",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "288546",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.