Active NPI
Jennifer Sue Rozum, MD
- Emergency Medicine Physician
- Las Vegas, NV
National Provider Identifier
1487656955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 10814
- Practice address
- 3100 N Tenaya Way
Las Vegas, NV 89128-0436 - Phone
- (702) 255-5025
- Fax
- (702) 255-5015
- NPI assigned
- Aug 12, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 10814 | NV | Primary |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 10814 | NV |
Addresses
Primary practice location
3100 N Tenaya Way
Las Vegas, NV 89128-0436
Mailing address
8200 Soaring Owl Ave
Las Vegas, NV 89129-1832
Phone (702) 396-9147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100503112 | Medicaid | NV |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10814 | NV | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248739200000",
"number": "1487656955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 SOARING OWL AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891291832",
"telephone_number": "702-396-9147",
"fax_number": "702-396-5013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 N TENAYA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280436",
"telephone_number": "702-255-5025",
"fax_number": "702-255-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZUM",
"first_name": "JENNIFER",
"middle_name": "SUE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-12",
"last_updated": "2009-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NV",
"license": "10814",
"primary": true
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "NV",
"license": "10814",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100503112",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.