Destiny L Rose, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4412 Issued in OK

Practice address

2000 E 15TH St Ste 400a
Edmond, OK 73013-6673

Phone

(405) 692-1557

NPI assigned

Oct 29, 2020

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

• Destiny L Shelton Former name

Medicare fee-for-service enrollment

Enrolled in OK

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 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1780697813
  Medicare reassignment
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1770826661
  NPD
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1942045455
  NPD
• Diana Oconnor DO PC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1669613444
  NPD (past)
• Stanbro Healthcare Group LLC

  • Child & Adolescent Psychiatry Physician
  • Edmond, OK
  • NPI 1942592886
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1588264402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E 15TH ST STE 400A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136673",
            "telephone_number": "405-341-1697",
            "fax_number": "405-341-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E 15TH ST STE 400A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136673",
            "telephone_number": "405-692-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DESTINY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESTINY",
            "last_name": "SHELTON",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Roper, PHARMD
• Rosado Consulting LLC
• Rosalynn J English, Ms,LMFT
• Kristen Michele Rosanelli, MA
• Cynthia Rose
• Madeline Bret Roseke
• Michele Rosendo
• J Dustin Rosenhamer, MD
• Katie Rosenthal, MED, LPC CANDIDATE
• Molly Ross Fuhrman, M.A., L.P.C.

• Medical Physician Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.