Michael Barry Rose, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

00977 Issued in MD

Practice address

6192 Oxon Hill Rd
Suite 403
Oxon Hill, MD 20745-3143

Phone

(301) 567-7791

Fax

(301) 567-7795

NPI assigned

Dec 28, 2006

Last updated

Jan 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1427114305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6208 SYDNEY RD",
            "address_2": "SUITE 403",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220391689",
            "telephone_number": "301-567-7791",
            "fax_number": "301-567-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6192 OXON HILL RD",
            "address_2": "SUITE 403",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453143",
            "telephone_number": "301-567-7791",
            "fax_number": "301-567-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MICHAEL",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "00977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115011100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.