Roshawna Iman, PNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

80117 Issued in WV

Practice address

9000 Coombs Farm Rd Ste 102
Morgantown, WV 26508-1150

Phone

(304) 599-8003

Fax

(304) 599-8003

NPI assigned

Aug 21, 2018

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

Other names 1

• Roshawna Mongold Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Cardinal Pediatrics PLLC

  • Pediatrics Physician
  • Morgantown, WV
  • NPI 1548272651
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1508346289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051876",
            "telephone_number": "304-599-8000",
            "fax_number": "304-599-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 102",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-599-8003",
            "fax_number": "304-599-8003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1247 Suncrest Town Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265051876",
            "country_code": "US",
            "telephone_number": "304-599-8000",
            "fax_number": "304-599-8003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "139 Conference Center Way Ste 113",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263309147",
            "country_code": "US",
            "telephone_number": "304-599-8003",
            "fax_number": "304-599-8003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Tygart Mall Loop Ste 102A",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265542972",
            "country_code": "US",
            "telephone_number": "304-599-8003",
            "fax_number": "304-599-8003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMAN",
        "first_name": "ROSHAWNA",
        "credential": "PNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "80117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSHAWNA",
            "last_name": "MONGOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nsisong Anthony Ikpa Sr., M.D., M.S.
• Samar Ikram, MD
• Haley Nicole Ilcewicz
• Sharadyn Nicole Ille, DMD
• Nathaniel O Iloanusi
• In Tune Counseling LLC
• Ketaki Inamdar
• Kristin Indermuhle, NP-C
• Alexander Thomas Infante
• Zachary L Ingram, OTR

• Pediatric Nurse Practitioner in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Pediatric Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.