Active NPI
Ann W Rose, PA-C
- Medical Physician Assistant
- Eugene, OR
National Provider Identifier
1285686097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00290
- Practice address
- 10 Coburg Rd.
#201
Eugene, OR 97401 - Phone
- (541) 726-4686
- Fax
- (541) 726-5056
- NPI assigned
- May 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00290 | OR | Primary |
Addresses
Primary practice location
10 Coburg Rd.
#201
Eugene, OR 97401
Mailing address
10 Coburg Rd.
#201
Eugene, OR 97401
Phone (541) 726-4686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136523 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00290 | OR | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane Gastroenterology Associates PC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Gastroenterology Physician
- Eugene, OR
- NPI 1639122187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292284800000",
"number": "1285686097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 COBURG RD.",
"address_2": "#201",
"city": "EUGENE",
"state": "OR",
"postal_code": "97401",
"telephone_number": "541-726-4686",
"fax_number": "541-726-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 COBURG RD.",
"address_2": "#201",
"city": "EUGENE",
"state": "OR",
"postal_code": "97401",
"telephone_number": "541-726-4686",
"fax_number": "541-726-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ANN",
"middle_name": "W",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2010-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OR",
"license": "PA00290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136523",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.