Olivia Denise Rose, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004954 Issued in VA

Practice address

100 15TH St NW
Suite a
Norton, VA 24273-1616

Phone

(276) 439-1840

Fax

(276) 439-1845

NPI assigned

Jul 31, 2011

Last updated

Feb 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Cutting Edge Dermatology PLLC

  • Dermatology Physician
  • Wise, VA
  • NPI 1770877987
  Medicare reassignment
• Western Virginia Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Norton, VA
  • NPI 1386183028
  Medicare reassignment
• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment
• Appalachian Emergency Physicians

  • Emergency Medicine Physician
  • Erwin, TN
  • NPI 1932451291
  NPD

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

{
    "created_epoch": "1312070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1457639072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "address_2": "SUITE A",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-439-1840",
            "fax_number": "276-439-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "address_2": "SUITE A",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-439-1840",
            "fax_number": "276-439-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "OLIVIA",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-31",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004954",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "1642",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457639072",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Harlan Roberson
• Donald L Roberts, MD
• Teresa Lynn Robinson, FNP-BC
• Veronica Robinson, D.O.
• Justin Scott Rose, CRNA
• Vada Alberta Rose, N.P.
• Wendy N Rumley, FNP
• Christopher Russell, LPC
• Zaynah Sadiq, MD
• Bradley A Salyer

• Physician Assistant in Norton, VA
• Providers in Norton, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.

Verify at the official NPI Registry.