Individual provider Active NPI

Donna Rose

  • Child Mental Illness Respite Care
  • Tucson, AZ
National Provider Identifier
1134469554
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
8419 Issued in AZ
Practice address
8128 N Ivory Rose Dr
Tucson, AZ 85741-4050
Phone
(520) 572-3908
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 8419 AZ Primary

Addresses

Primary practice location

8128 N Ivory Rose Dr
Tucson, AZ 85741-4050

Mailing address

8128 N Ivory Rose Dr
Tucson, AZ 85741-4050
Phone (520) 572-3908

Other identifiers 1

IdentifierTypeStateIssuer
8419OtherAZOLCR LICENSE

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

State licenses

LicenseStateTypeSpecialty
8419AZMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1134469554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8128 N IVORY ROSE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857414050",
            "telephone_number": "520-572-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8128 N IVORY ROSE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857414050",
            "telephone_number": "520-572-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "8419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLCR LICENSE",
            "identifier": "8419",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.