Individual provider Active NPI

Callasandra Rose, D.O.

  • Emergency Medicine Physician
  • College Station, TX
National Provider Identifier
1356796957
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S2488 Issued in TX
Practice address
700 Scott and White Dr
College Station, TX 77845-6441
Phone
(979) 207-0100
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S2488 TX Primary

Addresses

Primary practice location

700 Scott and White Dr
College Station, TX 77845-6441

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 1

IdentifierTypeStateIssuer
5315075272OtherMICONTROLLED SUBSTANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crose694757@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20200415001195 TX Practitioner - Emergency Medicine 2264726009 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
S2488TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Scott & White Clinic Emergency Medicine Current Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Scott & White Clinic Emergency Medicine CurrentSince May 15, 2020 Accepting new patients

Locations

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: crose694757@direct.sw.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1356796957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CALLASANDRA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S2488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "5315075272",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crose694757@direct.sw.org",
            "affiliation": "N",
            "address_1": "700 Scott and White Dr",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778456441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.