Active NPI
Renee Elaine Rose-Lynville, CAS
- Specialist
- Lotus, CA
National Provider Identifier
1174969232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 03042343
- Practice address
- 838 Beach Court
Lotus, CA 95613 - Phone
- (530) 626-7252
- NPI assigned
- May 16, 2013
- Last updated
- May 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 03042343 | CA | Primary |
Addresses
Primary practice location
838 Beach Court
Lotus, CA 95613
Mailing address
P.O. Box 437
Coloma, CA 95613
Phone (530) 626-7252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03042343 | Other | CA | CERTIFIED SPECIALIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03042343 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368662400000",
"number": "1174969232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 437",
"city": "COLOMA",
"state": "CA",
"postal_code": "95613",
"telephone_number": "530-626-7252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "838 BEACH COURT",
"city": "LOTUS",
"state": "CA",
"postal_code": "95613",
"telephone_number": "530-626-7252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE-LYNVILLE",
"first_name": "RENEE",
"middle_name": "ELAINE",
"credential": "CAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-16",
"last_updated": "2013-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "03042343",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED SPECIALIST",
"identifier": "03042343",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lotus, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.