Roxanne Mae Rose, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2096 Issued in ND

Practice address

217 Grandview Ave
Devils Lake, ND 58301-4123

Phone

(701) 662-5590

Fax

(701) 665-3252

NPI assigned

Apr 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• A New Horizons Counseling Services LLC

  • Clinical Social Worker
  • Devils Lake, ND
  • NPI 1558731257
  Medicare reassignment Authorized official
• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885

  Psychologist

  NPD (past)
• Peterson Medical Clinics, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1699295774
  NPD (past)

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1124084942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 GRANDVIEW AVE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583014123",
            "telephone_number": "701-662-5590",
            "fax_number": "701-665-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 GRANDVIEW AVE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583014123",
            "telephone_number": "701-662-5590",
            "fax_number": "701-665-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ROXANNE",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19124",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BC",
            "identifier": "23117",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BC/BS",
            "identifier": "24043",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181620900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BC/BS",
            "identifier": "284K8DA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "N715569",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Grace Robertson, LSW
• Cheyenne Rode, LPN
• Nicole Marie Rogers
• Nicole Ann Rohn
• Rachelle Romfo, MS-CCCSP
• Nicole Jean Rosencrantz, RN
• Ashley Roulette, CCHW, PPSS, LTA
• Lori Russell, QSP
• Briana Ryba
• Carl Sad, DC

• Psychologist in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.