Organization Active NPI

Rose Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Abilene, TX
National Provider Identifier
1295590586
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ROSE ANESTHESIA PLLC
Practice address
2217 S Danville Dr
Abilene, TX 79605-4719
Phone
(325) 675-6466
Fax
(325) 692-6030
NPI assigned
Feb 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Poppy A Walker, MBA
Title
Practice Administrator
Phone
(325) 675-6466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2217 S Danville Dr
Abilene, TX 79605-4719

Mailing address

3301 S 14TH St Ste 16180
Abilene, TX 79605-5015
Phone (325) 675-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240320003790 TX Part B Supplier - Clinic/Group Practice 9133566516 Receives reassigned benefits from 2 practitioners
Practice locations: Abilene, TX

National Provider Directory

National Provider Directory

Locations

2217 S Danville Dr
Abilene, TX 79605
Phone (325) 695-0600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1295590586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 S 14TH ST STE 16180",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796055015",
            "telephone_number": "325-675-6466",
            "fax_number": "325-692-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 S DANVILLE DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054719",
            "telephone_number": "325-675-6466",
            "fax_number": "325-692-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "POPPY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "325-675-6466",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.