Mark Rosenberger

Primary specialty

DriverTaxonomy code 172A00000X

License

Z996251476524 Issued in MN

Practice address

820 Albany Ave
Albany, MN 56307-9328

Phone

(320) 339-0474

NPI assigned

Aug 2, 2023

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 9, 2023.

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1285316976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 ALBANY AVE",
            "city": "ALBANY",
            "state": "MN",
            "postal_code": "563079328",
            "telephone_number": "320-339-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ALBANY AVE",
            "city": "ALBANY",
            "state": "MN",
            "postal_code": "563079328",
            "telephone_number": "320-339-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERGER",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MN",
            "license": "Z996251476524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STS",
            "identifier": "384666",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Albany, MN
• Driver in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.