Individual provider Active NPI

Leona Carol Rose, CRNP

  • Family Nurse Practitioner
  • Cherokee, AL
National Provider Identifier
1275805202
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-105688 Issued in AL
Practice address
1080 2ND St
Cherokee, AL 35616-7328
Phone
(256) 359-4519
Fax
(256) 359-4516
NPI assigned
Feb 7, 2012
Last updated
Aug 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-105688 AL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-105688 AL

Addresses

Primary practice location

1080 2ND St
Cherokee, AL 35616-7328

Mailing address

PO Box 2587
Muscle Shoals, AL 35662-2587
Phone (256) 383-4473

Other identifiers 1

IdentifierTypeStateIssuer
1326373861OtherALGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000731 AL Practitioner - Nurse Practitioner 4880854959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Center for Mental HealthGroup PAC ID 6507821048, 15 clinicians

Practice addresses (Care Compare)

205 Jackson Ave S
Russellville, AL 35653-2233
Phone (256) 332-3971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-105688ALMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Center for Mental Health CurrentSince Sep 1, 2015 Accepting new patients

Locations

635 W College St
Florence, AL 35630
Phone (256) 764-3431

205 Jackson Ave S
Russellville, AL 35653
Phone (256) 332-3971

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1275805202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2587",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356622587",
            "telephone_number": "256-383-4473",
            "fax_number": "256-381-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 2ND ST",
            "city": "CHEROKEE",
            "state": "AL",
            "postal_code": "356167328",
            "telephone_number": "256-359-4519",
            "fax_number": "256-359-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LEONA",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-105688",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-105688",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1326373861",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, AL

Sources for this page

Verify at the official NPI Registry.