Individual provider Active NPI

Rosemary L Staten, APN

  • Family Nurse Practitioner
  • Alton, IL
National Provider Identifier
1376809525
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000859 Issued in IL
Practice address
2 Saint Anthonys Way Ste 101
Alton, IL 62002-4580
Phone
(618) 463-0689
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277000859 IL Primary

Addresses

Primary practice location

2 Saint Anthonys Way Ste 101
Alton, IL 62002-4580

Mailing address

2 Saint Anthonys Way Ste 101
Alton, IL 62002-4580
Phone (618) 463-0689

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rosemary.staten.1@9559.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20120523000703 IL Practitioner - Nurse Practitioner 1951564210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
277000859ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Staten Family Practice PLLC CurrentSince Jul 10, 2020 Accepting new patients
Metro East Healthcare Limited CurrentSince Jul 1, 2021 Accepting new patients

Locations

27 Auerbach Pl
Glen Carbon, IL 62034
Phone (618) 277-3700

Interoperability endpoints

  • Direct secure messaging: rosemary.staten.1@9559.direct.athenahealth.com
  • Direct secure messaging: rosemary.staten@115443077021700.direct.elationemr.com
  • Direct secure messaging: rosemary.staten.p30@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 2

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1376809525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT ANTHONYS WAY STE 101",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024580",
            "telephone_number": "618-463-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT ANTHONYS WAY STE 101",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024580",
            "telephone_number": "618-463-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "ROSEMARY",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rosemary.staten.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Saint Anthonys Way Ste 101",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620024580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.