Rose Iyewarun, PHD

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

1867 Issued in MO

Practice address

6311 Evanston Ave
Raytown, MO 64133-4929

Phone

(816) 272-2533

NPI assigned

Feb 25, 2019

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Xtracare Adult Day Care Center, LLC.

  • Adult Day Care Clinic/Center
  • Raytown, MO
  • NPI 1952727273
  NPD Authorized official
• Confidence Consumer Directed Services LLC

  • Adult Care Home Facility
  • Raytown, MO
  • NPI 1700253150
  Authorized official Same address or phone

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1538626650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 EVANSTON AVE",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334929",
            "telephone_number": "816-328-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 EVANSTON AVE",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334929",
            "telephone_number": "816-272-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYEWARUN",
        "first_name": "ROSE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MO",
            "license": "1867",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952727273",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700253150",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Individual Expressions, Inc
• Infuse IV Therapy LLC
• Innovative Pharmaceutical Services Inc. (Sam's Prescription Shop)
• Francisco Javier Inzunza Santiago
• Anne Elizabeth Isinger, DDS
• Donica Chivon Jackson, CPTA
• Rubelita James, DDS
• Jeffrey L. Nixon L.L.C.
• Jessica Lane Re, LLC (The Recovery Village Kansas City)
• Callie Rae Johnson

• Adult Day Care Clinic/Center in Raytown, MO
• Providers in Raytown, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.