Active NPI
John M Rosen, MD
- Pediatric Gastroenterology Physician
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- E-13757
- Practice address
- 1 Childrens Way # 203
Little Rock, AR 72202-3500 - Phone
- (501) 364-3933
- Fax
- (501) 364-2939
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E-13757 | AR | |
| Pediatric Gastroenterology Physician | 2080P0206X | 0436401 | KS | |
| Pediatric Gastroenterology Physician | 2080P0206X | 2013014796 | MO | |
| Pediatric Gastroenterology Physician | 2080P0206X | E-13757 | AR | Primary |
Addresses
Primary practice location
1 Childrens Way # 203
Little Rock, AR 72202-3500
Mailing address
1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100
Other practice location 1
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 983-6926
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-13757 | AR | MD | Pediatric Gastroenterology Physician |
| 0436401 | KS | MD | Pediatric Gastroenterology Physician |
| 2013014796 | MO | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Children'S Hospital | Current | Accepting new patients | |
| Arkansas Childrens Professional Services Organization LLC | Pediatrics | Current | Accepting new patients |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Pediatrics | Current | Accepting new patients |
| Arkansas Childrens Hospital | Pediatrics | Current | Accepting new patients |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| Arkansas Childrens Northwest, Inc. | Past | Accepting new patients |
Locations
4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278
1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874
1 Childrens Way
#203
Little Rock, AR 72202
Phone (501) 364-2180
1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006
1 Childrens Way
Ste 653
Little Rock, AR 72202
Interoperability endpoints
- https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4
- jrosen281275@direct.kuha.org
Organizations & group practices 7
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.
-
- Pediatrics Physician
- Little Rock, AR
- NPI 1598773079
-
- Pediatrics Physician
- Little Rock, AR
- NPI 1629889464
-
- Pediatrics Physician
- Little Rock, AR
- NPI 1346230968
-
- Children's Hospital
- Little Rock, AR
- NPI 1477561983
-
- Family Medicine Physician
- El Dorado, AR
- NPI 1023795051
-
- General Practice Physician
- Little Rock, AR
- NPI 1336533041
-
- Children's Hospital
- Springdale, AR
- NPI 1255875746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711065600000",
"number": "1407073422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS WAY # 653",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-1100",
"fax_number": "501-364-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS WAY # 203",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-3933",
"fax_number": "501-364-2939"
}
],
"practiceLocations": [
{
"address_1": "2401 Gillham Rd",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641084619",
"country_code": "US",
"telephone_number": "816-983-6926",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSEN",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2024-03-22",
"certification_date": "2024-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AR",
"license": "E-13757",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "KS",
"license": "0436401",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MO",
"license": "2013014796",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "AR",
"license": "E-13757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.