Individual provider Active NPI

Virginia Jeanne Roseman, PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1417960428
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103493 Issued in NC
Practice address
200 Medical Park Dr
Ste 230
Concord, NC 28025-2982
Phone
(704) 403-1349
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103493 NC Primary

Addresses

Primary practice location

200 Medical Park Dr
Ste 230
Concord, NC 28025-2982

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vroseman631696@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050420000595 NC Practitioner - Physician Assistant 1557309515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103493NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 29, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 29, 2018 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

200 Medical Park Dr
Ste 230
Concord, NC 28025
Phone (704) 403-1349

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: vroseman631696@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: providersw2@direct.lumeris.com

Organizations & group practices 3

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 2

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1417960428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "STE 230",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-1349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEMAN",
        "first_name": "VIRGINIA",
        "middle_name": "JEANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vroseman631696@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 230",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.