Stacey Michelle Rosevear, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4833428-1206 Issued in UT

Practice address

3116 S 2700 E
Salt Lake City, UT 84109-2823

Phone

(801) 201-2475

NPI assigned

Feb 27, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• U-U Pediatric Dermatology

  • Pediatric Dermatology Physician
  • Salt Lake City, UT
  • NPI 1235339193
  NPD (past)
• Utah Valley Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Provo, UT
  • NPI 1265483598
  NPD (past)

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1316362353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 S 2700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092823",
            "telephone_number": "801-201-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 S 2700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092823",
            "telephone_number": "801-201-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEVEAR",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4833428-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4833428-8906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Rosenlund
• Emily Rosenthal, MD
• Regina Ellen Rosenthal, MD
• Lauren L Roser, CRNA
• Spencer J Rosero
• Rosewood Assisted Care Inc
• Evelyn K Rosier, LCSW
• Pamala Diane Roskelley-Johnson, LPC
• Annmarie Vanorden Roskelley, SSW
• Allison Rosko, RDN

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.