Courtney E Rose, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N9947 Issued in TX

Practice address

203 Nacogdoches St
Suite 275
Jacksonville, TX 75766-2462

Phone

(309) 541-5472

Fax

(903) 541-5470

NPI assigned

Jun 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crose355056@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Jacksonville Hospital LLC

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  NPD (past)
• Starks Medical

  • Primary Care Nurse Practitioner
  • Bullard, TX
  • NPI 1306570593
  NPD (past)

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1265727457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 NACOGDOCHES ST",
            "address_2": "SUITE 275",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662462",
            "telephone_number": "309-541-5472",
            "fax_number": "903-541-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 NACOGDOCHES ST",
            "address_2": "SUITE 275",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662462",
            "telephone_number": "309-541-5472",
            "fax_number": "903-541-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "COURTNEY",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N9947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaila Sue Rice, LPCI
• Rigsby Chiropractic, PLLC
• Martin E Rivera, CRNA
• Louis C. Roach, MD
• Linda M Rodriguez, RN
• Dylan W Rutherford, D.D.S.
• Stephanie R Ryle, NP
• Guillermo Alfonso Saade, MD
• Sam L. Smith DC,PC
• Bryan Taylor Sanchez

• Pediatrics Physician in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.