Individual provider Active NPI

James Keith Rose, M.D.

  • Emergency Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1225192248
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J4486 Issued in TX
Practice address
5536 Saratoga Blvd
Corpus Christi, TX 78413-2944
Phone
(361) 992-0227
Fax
(361) 992-0669
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X J4486 TX
Emergency Medicine Physician 207P00000X J4486 TX Primary

Addresses

Primary practice location

5536 Saratoga Blvd
Corpus Christi, TX 78413-2944

Mailing address

5536 Saratoga Blvd
Corpus Christi, TX 78413-2944
Phone (361) 992-0227

Other identifiers 1

IdentifierTypeStateIssuer
084171001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000801 TX Practitioner - Family PracticePractitioner - General Practice 6002804986 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Texas Medical Branch at Galveston, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CC Doctors Center Portland, PLLCGroup PAC ID 8729467956, 2 clinicians
Nueces Emergency Services PAGroup PAC ID 0749566628, 3 clinicians

Practice addresses (Care Compare)

125 Northshore Blvd
Portland, TX 78374-4206
Phone (361) 480-0334

4637 S Padre Island Dr
Corpus Christi, TX 78411-4413
Phone (361) 852-6824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J4486TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CC Doctors Center Portland, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Daniela Badea-Mic MD, PA Past Accepting new patients
Thirty Third Health Services, PLLC Past Accepting new patients

Locations

4637 Spid Dr
Corpus Christi, TX 78411
Phone (361) 452-5632

125 Northshore Blvd
Portland, TX 78374
Phone (361) 480-0334

Interoperability endpoints

  • Direct secure messaging: james.rose.1@31783.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1225192248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 SARATOGA BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784132944",
            "telephone_number": "361-992-0227",
            "fax_number": "361-992-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 SARATOGA BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784132944",
            "telephone_number": "361-992-0227",
            "fax_number": "361-992-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JAMES",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "J4486",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J4486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084171001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.