Active NPI
Miko Rose, D.O.
- Psychiatry Physician
- East Lansing, MI
National Provider Identifier
1285864843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 5101019168
- Practice address
- A233 East Fee Hall
Gen Adult Psychiatry Residency Msu
East Lansing, MI 48824-1316 - Phone
- (517) 432-2993
- NPI assigned
- Jul 16, 2009
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 5101019168 | MI | Primary |
Addresses
Primary practice location
A233 East Fee Hall
Gen Adult Psychiatry Residency Msu
East Lansing, MI 48824-1316
Mailing address
5303S Cedar St
Lansing, MI 48911-3800
Phone (517) 244-8060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285864843 | Medicaid | MI |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101019168 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445558400000",
"number": "1285864843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5303S CEDAR ST",
"city": "LANSING",
"state": "MI",
"postal_code": "489113800",
"telephone_number": "517-244-8060",
"fax_number": "517-244-7180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "A233 EAST FEE HALL",
"address_2": "GEN ADULT PSYCHIATRY RESIDENCY MSU",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488241316",
"telephone_number": "517-432-2993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "MIKO",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-16",
"last_updated": "2015-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5101019168",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1285864843",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.