Individual provider Active NPI

Chris R Rosenquist, M.D.

  • Obstetrics & Gynecology Physician
  • Cape Girardeau, MO
National Provider Identifier
1174525539
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R5J73 Issued in MO
Practice address
1111 N Mount Auburn Rd
Cape Girardeau, MO 63701-3437
Phone
(573) 339-1101
Fax
(573) 339-1737
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R5J73 MO Primary
Obstetrics & Gynecology Physician 207V00000X 31341 KY

Addresses

Primary practice location

1111 N Mount Auburn Rd
Cape Girardeau, MO 63701-3437

Mailing address

1111 N Mount Auburn Rd
Cape Girardeau, MO 63701-3437
Phone (573) 339-1101

Other identifiers 4

IdentifierTypeStateIssuer
135347OtherMOHEALTHLINK
202662417MedicaidMO
31341OtherKYSTATE LICENSE
117028OtherMOBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000936 MO Practitioner - Obstetrics/Gynecology 5890876015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Missouri, Columbia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

650 S Mount Auburn Rd
Suite 200
Cape Girardeau, MO 63703-4941
Phone (573) 339-1101

Hospital & facility affiliations

  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31341KYMDObstetrics & Gynecology Physician
R5J73MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Hospital Current Accepting new patients
Southeast Missouri Hospital Physicians, LLC Obstetrics & Gynecology CurrentSince Mar 1, 2014 Accepting new patients

Locations

650 S Mount Auburn Rd
Ste 200
Cape Girardeau, MO 63703
Phone (573) 339-1101

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1111 N Mount Auburn Rd
Cpe Girardeau, MO 63701
Phone (573) 332-6000

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1174525539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013437",
            "telephone_number": "573-339-1101",
            "fax_number": "573-339-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013437",
            "telephone_number": "573-339-1101",
            "fax_number": "573-339-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENQUIST",
        "first_name": "CHRIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R5J73",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "31341",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "135347",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202662417",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "31341",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "117028",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.