Individual provider Active NPI

Nathaniel Rosol, MD

  • Military Health Care Provider
  • Tinker AFB, OK
National Provider Identifier
1598221434
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
Practice address
7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716
Phone
(405) 734-2778
NPI assigned
Feb 15, 2019
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Military Health Care Provider 171000000X Primary

Addresses

Primary practice location

7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716

Mailing address

7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716

Other practice location 1

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002003844 NE Order and Referring Only - UrologyPractitioner - Urology 8729519632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9832NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1598221434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-734-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSOL",
        "first_name": "NATHANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-15",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinker AFB, OK

Sources for this page

Verify at the official NPI Registry.