Active NPI
Jonathan W Rouse, MD
- Anatomic Pathology & Clinical Pathology Physician
- Omaha, NE
National Provider Identifier
1184680993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 17631
- Practice address
- 4955 F Street
Omaha, NE 68106 - Phone
- (402) 717-2870
- Fax
- (402) 717-5231
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | 17631 | NE | |
| Cytopathology Physician | 207ZC0500X | 28682 | IA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 17631 | NE | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 28682 | IA |
Addresses
Primary practice location
4955 F Street
Omaha, NE 68106
Mailing address
PO Box 4907
Omaha, NE 68104
Phone (800) 831-2402
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47016 | Other | IA | BCBS |
| 06294 | Other | NE | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28682 | IA | MD | Cytopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1184680993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4907",
"city": "OMAHA",
"state": "NE",
"postal_code": "68104",
"telephone_number": "800-831-2402",
"fax_number": "770-666-9514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4955 F STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "68106",
"telephone_number": "402-717-2870",
"fax_number": "402-717-5231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSE",
"first_name": "JONATHAN",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NE",
"license": "17631",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "IA",
"license": "28682",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NE",
"license": "17631",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IA",
"license": "28682",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "47016",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "06294",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.