Luke Rosen, DO, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LUKE ROSEN, DO, PLLC

Practice address

1174 Alturas Dr Unit 4B
Moscow, ID 83843-8341

Phone

(360) 828-8130

Fax

(360) 785-2171

NPI assigned

Jul 24, 2018

Organization subpart

No

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

Authorized official

Name

Luke Billmeyer Rosen, DONPI 1194040576

Title

Owner

Phone

(360) 828-8130

Specialties & licenses 4

Addresses

Other names 1

• PsychNS Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luke Billmeyer Rosen, DO

  • Psychiatry Physician
  • Moscow, ID
  • NPI 1194040576
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1184101073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 ALTURAS DR UNIT 4B",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438341",
            "telephone_number": "360-828-8130",
            "fax_number": "360-785-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 ALTURAS DR UNIT 4B",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438341",
            "telephone_number": "360-828-8130",
            "fax_number": "360-785-2171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 NE 134th St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986863026",
            "country_code": "US",
            "telephone_number": "360-828-8130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUKE ROSEN, DO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "BILLMEYER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-828-8130",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "WA",
            "license": "OP60447877",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP60447877",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PsychNS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vicky M Lott, M.D.
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• Michael Lounsbury, PAC
• Kayla J Love
• Catherine Mae Luna
• Teleea Tawnee Lundgren, LMT, NCTMB
• James Rion Lutz
• Douglas Patrick Lynch, DPT
• Michele Lynch, LCPC

• Psychiatry Physician in Moscow, ID
• Providers in Moscow, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.