Amy Roselius

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1-090081 Issued in AL

Practice address

3124 Ross Clark Cir
Dothan, AL 36303-3038

Phone

(334) 678-9123

Fax

(334) 678-9124

NPI assigned

Aug 11, 2015

Last updated

Aug 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Extended Care Medical Associates LLC

  • Family Medicine Physician
  • Dothan, AL
  • NPI 1902182371
  Medicare reassignment NPD
• Leg Health Vascular Centers, Inc

  • Vascular Surgery Physician
  • Auburn, AL
  • NPI 1518570068
  NPD (past)
• Occmed Solutions LLC

  • Occupational Medicine Clinic/Center
  • Dothan, AL
  • NPI 1093070187
  NPD (past)

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1184090359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033038",
            "telephone_number": "334-678-9123",
            "fax_number": "334-678-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033038",
            "telephone_number": "334-678-9123",
            "fax_number": "334-678-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELIUS",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-090081",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-090081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaycee Rolf
• Susanne Alice Marie Roman
• Rooted in Resilience Therapy Services, LLC
• Sachary Rosado Caraballo, MD
• Whitnye Robin Rose
• Rosestone Infectious Disease Care LLC
• Ross Clark Circle Dialysis LLC (Wiregrass Kidney Center)
• Ross P. Davis MD PC
• Jean Elizabeth Ross, CRNP
• Melea A Ross, AT

• Adult Health Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Adult Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.