Active NPI
Colin James Rose, MD
- General Practice Physician
- Jbsa Lackland, TX
National Provider Identifier
1487398111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 70127
- Practice address
- 1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 292-5350
- NPI assigned
- Apr 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 70127 | TN | Primary |
| Military Health Care Provider | 171000000X |
Addresses
Primary practice location
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Mailing address
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 292-5350
Other practice location 1
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-2474
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70127 | TN | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1487398111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-5350"
}
],
"practiceLocations": [
{
"address_1": "1 Jarrett White Rd",
"address_purpose": "LOCATION",
"city": "Tripler Army Medical Center",
"state": "HI",
"postal_code": "968595001",
"country_code": "US",
"telephone_number": "808-433-2474",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSE",
"first_name": "COLIN",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-27",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "TN",
"license": "70127",
"primary": true
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.