David Clarence Rose, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD30077 Issued in DC

Practice address

6192 Devon Dr
Columbia, MD 21044-3821

Phone

(443) 528-2874

NPI assigned

Oct 17, 2007

Last updated

Sep 2, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth of Virginia State Board of Health

  dba Alexandria Health Department

  • Public Health or Welfare Agency
  • Alexandria, VA
  • NPI 1275669277

  DC

  Medicare reassignment NPD
• Commonwealth of Virginia State Board of Health

  dba Nelson County Health Department

  • Public Health or Welfare Agency
  • Arrington, VA
  • NPI 1679580922
  NPD
• Potomac Physicians PA

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1790706844

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1336338185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6192 DEVON DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443821",
            "telephone_number": "443-528-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6192 DEVON DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443821",
            "telephone_number": "443-528-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DAVID",
        "middle_name": "CLARENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05852400",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0046839",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD30077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034538700",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8751404",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133469",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fnu Roohi Baig
• Rooted Minds Behavioral Health Services
• Rooted Physio, LLC (Rooted Physio & Performance)
• Rooted Strength Physical Therapy
• Tyler Rosado
• Isabel Burick Rose
• Jacqueline Eva Rose, MD
• Jamie Larae Rose
• Lisa Rose, RN
• Taylor Rose

• Pediatrics Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.