Active NPI
Rebekah Rosenbaum
- Dental Hygienist
- Saint Joseph, MI
National Provider Identifier
1245858687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- 2525 S Cleveland Ave
Saint Joseph, MI 49085-2649 - Phone
- (126) 942-9158
- NPI assigned
- Jul 13, 2020
- Last updated
- Jul 13, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902018625 | MI | |
| Dental Hygienist | 124Q00000X | Primary |
Addresses
Primary practice location
2525 S Cleveland Ave
Saint Joseph, MI 49085-2649
Mailing address
2525 S Cleveland Ave
Saint Joseph, MI 49085-2649
Phone (126) 942-9158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598117616 | Medicaid | MI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | stjoseph@secured-glfdg.com | ||
| Direct Messaging Address | stjoseph@secured-glfdg.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2902018625 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594598400000",
"number": "1245858687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 S CLEVELAND AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490852649",
"telephone_number": "126-942-9158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 S CLEVELAND AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490852649",
"telephone_number": "126-942-9158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBAUM",
"first_name": "REBEKAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-13",
"last_updated": "2020-07-13",
"certification_date": "2020-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902018625",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1598117616",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "stjoseph@secured-glfdg.com",
"affiliation": "N",
"address_1": "2525 S Cleveland Ave",
"city": "Saint Joseph",
"state": "MI",
"country_code": "US",
"postal_code": "490852649",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "stjoseph@secured-glfdg.com",
"affiliation": "N",
"address_1": "2525 S Cleveland Ave",
"city": "Saint Joseph",
"state": "MI",
"country_code": "US",
"postal_code": "490852649",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.