Individual provider Active NPI

Charelle Rose

  • Pediatric Oncology Registered Nurse
  • Charleston, SC
National Provider Identifier
1225618200
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Oncology Registered NurseTaxonomy code 163WP0218X
License
242569 Issued in SC
Practice address
47 Maplecrest Dr
Charleston, SC 29412-3751
Phone
(231) 557-5347
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Oncology Registered Nurse 163WP0218X 242569 SC Primary

Addresses

Primary practice location

47 Maplecrest Dr
Charleston, SC 29412-3751

Mailing address

47 Maplecrest Dr
Charleston, SC 29412-3751
Phone (231) 557-5347

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

State licenses

LicenseStateTypeSpecialty
242569SCMDPediatric Oncology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1225618200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MAPLECREST DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123751",
            "telephone_number": "231-557-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAPLECREST DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123751",
            "telephone_number": "231-557-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CHARELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "SC",
            "license": "242569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.