Scott Loray Rose, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA691 Issued in OK

Practice address

1110 N Lee Ave
Oklahoma City, OK 73103-2612

Phone

(405) 230-9000

Fax

(405) 230-9424

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Integrated Medical Incorporated

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1386448181
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1518966142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268981",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268981",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032612",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SCOTT",
        "middle_name": "LORAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Don Rose
• Makenna Cheyenne Rose
• Mickeeta Lashoone Rose
• Paden Elizabeth Rose
• Rita B Rose, PA
• Sonja Rose
• Stacey Lynn Rose, CNS
• Stevie Rose
• Taylor Rose
• Terrace Rose Sr.

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.

Verify at the official NPI Registry.