Individual provider Active NPI

Matthew B Rose, ORT/L, CHT

  • Hand Occupational Therapist
  • Georgetown, KY
National Provider Identifier
1538356381
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
R2604 Issued in KY
Practice address
101 Windsor Path
Suite 2
Georgetown, KY 40324-9617
Phone
(502) 863-1674
Fax
(502) 863-1676
NPI assigned
Sep 26, 2007
Last updated
Nov 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X R2604 KY Primary

Addresses

Primary practice location

101 Windsor Path
Suite 2
Georgetown, KY 40324-9617

Mailing address

101 Windsor Path
Suite 2
Georgetown, KY 40324-9617
Phone (502) 863-1674

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

State licenses

LicenseStateTypeSpecialty
R2604KYMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1538356381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WINDSOR PATH",
            "address_2": "SUITE 2",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249617",
            "telephone_number": "502-863-1674",
            "fax_number": "502-863-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WINDSOR PATH",
            "address_2": "SUITE 2",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249617",
            "telephone_number": "502-863-1674",
            "fax_number": "502-863-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "ORT/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "KY",
            "license": "R2604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.