Active NPI
Rose M Ross, FNP
- Family Nurse Practitioner
- Fairview, MI
National Provider Identifier
1225069412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704091848
- Practice address
- 1910 E Miller Rd
Fairview, MI 48621-8731 - Phone
- (989) 848-5484
- Fax
- (989) 848-7139
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704091848 | MI | Primary |
Addresses
Primary practice location
1910 E Miller Rd
Fairview, MI 48621-8731
Mailing address
1910 E Miller Rd
PO Box 460
Fairview, MI 48621-8731
Phone (989) 848-5484
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4747166 | Medicaid | MI | |
| 5008773530 | Other | MI | BCBS |
| 4747175 | Medicaid | MI | |
| 700G210140 | Other | MI | BC GROUP PIN |
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1225069412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 E MILLER RD",
"address_2": "PO BOX 460",
"city": "FAIRVIEW",
"state": "MI",
"postal_code": "486218731",
"telephone_number": "989-848-5484",
"fax_number": "989-848-7139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 E MILLER RD",
"city": "FAIRVIEW",
"state": "MI",
"postal_code": "486218731",
"telephone_number": "989-848-5484",
"fax_number": "989-848-7139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "ROSE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704091848",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4747166",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5008773530",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4747175",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC GROUP PIN",
"identifier": "700G210140",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairview, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.