Individual provider Active NPI

Jane Rebecca Roseboro, MA, CAP

  • Addiction (Substance Use Disorder) Counselor
  • Bradenton, FL
National Provider Identifier
1205191095
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
379 6TH Ave W
Bradenton, FL 34205-8820
Phone
(941) 782-4299
Fax
(941) 782-4301
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

379 6TH Ave W
Bradenton, FL 34205-8820

Mailing address

PO Box 9478
Bradenton, FL 34206-9478
Phone (941) 782-4100

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1205191095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9478",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342069478",
            "telephone_number": "941-782-4100",
            "fax_number": "941-782-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4299",
            "fax_number": "941-782-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBORO",
        "first_name": "JANE",
        "middle_name": "REBECCA",
        "credential": "MA,  CAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.