Nichole A Rosa, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP009050 Issued in PA

Practice address

433 Church St
New Milford, PA 18834-6603

Phone

(570) 465-4500

Fax

(570) 465-4501

NPI assigned

Nov 3, 2006

Last updated

Jan 7, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole A Macconnell Former name

Medicare fee-for-service enrollment

Enrolled in PA

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.

• Barnes-Kasson County Hospital

  • Critical Access Hospital
  • Susquehanna, PA
  • NPI 1932138161
  Medicare reassignment NPD
• Blue Ridge Medical Center

  • Family Nurse Practitioner
  • New Milford, PA
  • NPI 1164775342
  Authorized official Same address or phone
• Barnes-Kasson County Hospital

  • Rural Health Clinic/Center
  • Honesdale, PA
  • NPI 1659180388
  NPD
• Barnes-Kasson County Hospital

  dba Family Health Clinic of Barnes Kasson Hospital

  • Rural Health Clinic/Center
  • New Milford, PA
  • NPI 1497996037
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1194804815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 CHURCH ST",
            "address_2": "P.O. BOX 602",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188346603",
            "telephone_number": "570-465-4500",
            "fax_number": "570-465-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 CHURCH ST",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188346603",
            "telephone_number": "570-465-4500",
            "fax_number": "570-465-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "NICHOLE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334797",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "MACCONNELL",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Lee McHale, RN
• Northeast Shoe
• Michele Lynn Pavelski, DC
• Spencer R Renwick
• Restore Occupational Therapy
• Kim Rosencrans, MS
• Victoria Ann Rupakus, PT, MS
• Glendon Carl Summers, DC
• Andrea Venesky, LPC
• Taylor Wahlers, LAPC

• Family Nurse Practitioner in New Milford, PA
• Providers in New Milford, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.