Individual provider Active NPI

Amy J Rose, RN, LMT, CNMT

  • Nurse Massage Therapist (NMT)
  • Pueblo, CO
National Provider Identifier
1457618340
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X
License
RN.1623859 Issued in CO
Practice address
955 N Greenwood St
Pueblo, CO 81003-2927
Phone
(719) 256-0797
NPI assigned
Apr 16, 2012
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Massage Therapist (NMT) 163WM1400X RN.1623859 CO Primary
Massage Therapist 225700000X MT-8840 CO

Addresses

Primary practice location

955 N Greenwood St
Pueblo, CO 81003-2927

Mailing address

955 N Greenwood St
Pueblo, CO 81003-2927
Phone (719) 256-0797

Other practice location 1

3902 Sandalwood Ln Unit 140
Pueblo, CO 81005-7502
Phone (719) 256-0797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.1623859COMDNurse Massage Therapist (NMT)
MT-8840COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Massage Therapy, LLC Massage Therapist CurrentSince Oct 6, 2024 Accepting new patients

Locations

3902 Sandalwood Ln
Unit 140
Pueblo, CO 81005
Phone (719) 248-9797

955 N Greenwood St
Pueblo, CO 81003
Phone (719) 256-0797

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1457618340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 N GREENWOOD ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032927",
            "telephone_number": "719-256-0797",
            "fax_number": "719-285-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 N GREENWOOD ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032927",
            "telephone_number": "719-256-0797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3902 Sandalwood Ln Unit 140",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810057502",
            "country_code": "US",
            "telephone_number": "719-256-0797",
            "fax_number": "719-285-0781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "RN, LMT, CNMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "CO",
            "license": "RN.1623859",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT-8840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.