Active NPI
Blair Nicole Rose, PA-C
- Medical Physician Assistant
- Dallas, TX
National Provider Identifier
1497059034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 1717 Main St
5200
Dallas, TX 75201-4612 - Phone
- (214) 712-2444
- NPI assigned
- Dec 22, 2010
- Last updated
- Dec 22, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | TX | Primary |
Addresses
Primary practice location
1717 Main St
5200
Dallas, TX 75201-4612
Mailing address
804 Andersonville LN
Wylie, TX 75098-5304
Phone (972) 742-6091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellis Emergency Physicians PLLC | Past | Accepting new patients | |
| Plano Urgent Care LLC | Past | Accepting new patients | |
| Dallas Emergency Physicians PLLC | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Dallas, TX
- NPI 1447615711
-
- Emergency Medicine Physician
- Richardson, TX
- NPI 1427008523
-
- Emergency Medicine Physician
- Dallas, TX
- NPI 1457301756
-
- Emergency Medicine Physician
- Waxahachie, TX
- NPI 1902856107
-
- Urgent Care Clinic/Center
- Plano, TX
- NPI 1184036899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1497059034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 ANDERSONVILLE LN",
"city": "WYLIE",
"state": "TX",
"postal_code": "750985304",
"telephone_number": "972-742-6091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 MAIN ST",
"address_2": "5200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752014612",
"telephone_number": "214-712-2444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "BLAIR",
"middle_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-22",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.