Phillissa Kay Rozansky

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

RN.0124082 Issued in CO

Practice address

190 E Bannock St
Boise, ID 83712-6241

Phone

(303) 717-4168

NPI assigned

Sep 17, 2017

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Phillissa Kay Simpson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: prozansk92543@direct.slhs.org

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.

• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1505606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1336668730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "303-717-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZANSKY",
        "first_name": "PHILLISSA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-17",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CO",
            "license": "RN.0124082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN.0124082",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLISSA",
            "last_name": "SIMPSON",
            "middle_name": "KAY",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marcel Andrew Roy, MD
• Matthew Roy
• Royal Dental PLLC (Four Seasons Dentistry)
• Adisson D Roylance
• Phillip Kyle Roylance, CRNA
• Zhen Ruan
• Lydia Rubalcava, DPT
• Rubato Relations LLC
• Gabriella Nicole Rubio
• John Wyatt Ruby, CNRA

• Neonatal Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Neonatal Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.