Individual provider Active NPI

Leah M Rose, APRN

  • Nurse Practitioner
  • Saint Johns, FL
National Provider Identifier
1336769934
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11006156 Issued in FL
Practice address
1310 County Road 210 W
Saint Johns, FL 32259
Phone
(904) 824-4407
Fax
(904) 390-7459
NPI assigned
Apr 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11006156 FL
Nurse Practitioner 363L00000X APRN11006156 FL Primary

Addresses

Primary practice location

1310 County Road 210 W
Saint Johns, FL 32259

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

Other identifiers 1

IdentifierTypeStateIssuer
110108400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707000923 FL Practitioner - Nurse Practitioner 6002239209 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

120 Gateway Cir
Unit 1
Jacksonville, FL 32259-4083
Phone (904) 824-4407

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince May 3, 2021 Accepting new patients
Baptist Primary Care Inc CurrentSince Feb 28, 2022 Accepting new patients
Baptist Primary Care Inc. CurrentSince Feb 28, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince May 3, 2021 Accepting new patients
N E Florida Internal Medicine PA CurrentSince Jun 15, 2020 Accepting new patients
Baptist Primary Care Inc Nurse Practitioner Current Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

2065 Herschel St
Jacksonville, FL 32204
Phone (904) 387-3933

13155 Atlantic Blvd
Jacksonville, FL 32225
Phone (904) 221-2222

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

14540 Old St Augustine Rd
Ste 2317
Jacksonville, FL 32258
Phone (904) 202-2342

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

120 Gateway Cir
Unit 1
Saint Johns, FL 32259
Phone (904) 824-4407

1310 County Road 210 W
St Johns, FL 32259
Phone (904) 824-4407

Interoperability endpoints

  • Direct secure messaging: lrose20948@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1336769934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 COUNTY ROAD 210 W",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-824-4407",
            "fax_number": "904-390-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LEAH",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006156",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110108400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

Verify at the official NPI Registry.