Individual provider Active NPI

Rosamond Elaine McIntyre, LISW

  • Clinical Social Worker
  • Streetsboro, OH
National Provider Identifier
1306817093
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I4020 Issued in OH
Practice address
8916 Topaz Ter
Streetsboro, OH 44241-4110
Phone
(330) 650-2874
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I4020 OH Primary

Addresses

Primary practice location

8916 Topaz Ter
Streetsboro, OH 44241-4110

Mailing address

8916 Topaz Ter
Streetsboro, OH 44241-4110
Phone (330) 650-2874

Other identifiers 1

IdentifierTypeStateIssuer
2669607MedicaidOH

Other names 1

  • Mrs. Rose E. McIntyre Other name

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

State licenses

LicenseStateTypeSpecialty
I4020OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1306817093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8916 TOPAZ TER",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414110",
            "telephone_number": "330-650-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8916 TOPAZ TER",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414110",
            "telephone_number": "330-650-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "ROSAMOND",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I4020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2669607",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "MCINTYRE",
            "middle_name": "E.",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.