Individual provider Active NPI

Rosela Nielsen

  • Nurse Practitioner
  • Palm Springs, CA
National Provider Identifier
1497348726
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95016606 Issued in CA
Practice address
1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone
(760) 774-2160
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95016606 CA Primary

Addresses

Primary practice location

1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872

Mailing address

64033 Olympic Mountain Ave
Desert Hot Springs, CA 92240-7706
Phone (760) 774-2160

Other practice location 1

64033 Olympic Mountain Ave
Desert Hot Springs, CA 92240-7706
Phone (760) 774-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN2 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

Enrollment IDStateProvider typePAC IDDetails
I20210608003594 CA Practitioner - Nurse Practitioner 3971903212 Reassigns benefits to 1 organization
I20230208000007 TN Practitioner - Nurse Practitioner 3971903212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Physicians Practice LLC CurrentSince Jan 16, 2023 Accepting new patients
Athens Physicians Practice LLC CurrentSince Jan 16, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jun 1, 2021 Accepting new patients
Athens Physicians Practice, LLC Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Athens Physicians Practice LLC Past Accepting new patients

Locations

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770

800 S White St
Ste 4
Athens, TN 37303
Phone (423) 453-5085

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

8904 Hiwassee St NE
Charleston, TN 37310
Phone (423) 810-0031

872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585

Interoperability endpoints

  • Direct secure messaging: rosela.nielsen.1@19363.direct.athenahealth.com
  • Direct secure messaging: rnielsen368692@direct.llu.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1497348726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64033 OLYMPIC MOUNTAIN AVE",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922407706",
            "telephone_number": "760-774-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624872",
            "telephone_number": "760-774-2160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "64033 Olympic Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Desert Hot Springs",
            "state": "CA",
            "postal_code": "922407706",
            "country_code": "US",
            "telephone_number": "760-774-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "ROSELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.