Active NPI
Rose Pothen, M.D.
- Family Medicine Physician
- Fort Myers, FL
National Provider Identifier
1154323178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME68293
- Practice address
- 16271 Bass Rd
Ft Myers, FL 33908-3616 - Phone
- (239) 432-4235
- NPI assigned
- Aug 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME68293 | FL | Primary |
Addresses
Primary practice location
16271 Bass Rd
Ft Myers, FL 33908-3616
Mailing address
PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 424-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 378949700 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1154323178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-424-1400",
"fax_number": "239-424-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16271 BASS RD",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339083616",
"telephone_number": "239-432-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTHEN",
"first_name": "ROSE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-10",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME68293",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378949700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.