John Allen Brose

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50000880-15 Issued in WI

Practice address

1336 Creston Park Dr
Janesville, WI 53545-1119

Phone

(608) 752-8792

NPI assigned

Jun 30, 2008

Sex

Male

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 WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1275795429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 CRESTON PARK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 CRESTON PARK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451119",
            "telephone_number": "608-752-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSE",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "50000880-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Jade Brissette, LCSW
• Nikolina Brkovic, RD
• Rebecca Rose Brocken, MS CF-SLP
• Frank D Brodkey, MD
• Adam Thomas Brogley, LAT, ATC
• Brittany Chantelle Brown, MSN, FNP-BC
• Erika R Brown
• Karen Anne Brown, RPH
• Laurie A Brown, LPC, CSAC
• Marylou Brown, RN

• General Practice Dentistry in Janesville, WI
• Providers in Janesville, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.