Elizabeth Diane Rose, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

89605 Issued in SC

Practice address

300 East Hospital Road
Fort Gordon, GA 30905-5650

Phone

(706) 787-2567

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Medical University of South Carolina College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excelled Healing LLCGroup PAC ID 5092247874, 5 clinicians

Omni Wound Physicians PLLCGroup PAC ID 6800310699, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Excelled Healing LLC

  • Family Nurse Practitioner
  • Snohomish, WA
  • NPI 1013742964
  Medicare reassignment Care Compare group NPD
• Omni Wound Physicians PLLC

  • Surgery Physician
  • Valencia, CA
  • NPI 1023821055

  WA

  Medicare reassignment Care Compare group NPD
• Healogics Specialty Physicians of South Carolina, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Myrtle Beach, SC
  • NPI 1033531850

  Surgery

  Medicare reassignment NPD
• Steel Rose Surgical & Wound Care PLLC

  • Surgery Physician
  • Lacey, WA
  • NPI 1215863055
  NPD (past) Authorized official
• Healogics Specialty Physicians of South Carolina, LLC

  • Clinic/Center
  • Spartanburg, SC
  • NPI 1023677945
  NPD

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1457704033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ELIZABETH",
        "middle_name": "DIANE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "89605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thais Rodriguez Fletcher, CRNA
• Jorge M Rodriguez
• Lavinia Rodriguez, MSW
• Jonathan D Roebuck
• Kenneth B. Roland Jr., PA-C
• Patricia A. Ross, RN
• A Rafael Roure, MD
• Christopher James Ryals, FNP-BC
• Jennifer Victoria Sabol, DDS
• John David Sanders

• Surgery Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.