Active NPI
Sharon Rouse, DO
- Pediatrics Physician
- Jackson, MI
National Provider Identifier
1619973229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5101014228
- Practice address
- 505 N Jackson St
Jackson, MI 49201-1266 - Phone
- (517) 748-5500
- Fax
- (517) 780-9286
- NPI assigned
- Jun 28, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5101014228 | MI | Primary |
Addresses
Primary practice location
505 N Jackson St
Jackson, MI 49201-1266
Mailing address
505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4667950-11 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | srouse444805@direct.hfhs.org |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1071 | NV | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W. a. Foote Memorial Hospital, Inc. | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Pediatrics | Current | Accepting new patients |
| W.a. Foote Memorial Hospital, Inc | Current | Accepting new patients |
Locations
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
505 N Jackson St
Jackson, MI 49201
Phone (517) 748-5500
760 W Franklin St
Jackson, MI 49201
Phone (517) 205-1461
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jackson, MI
- NPI 1326078866
-
- Physician Assistant
- Jackson, MI
- NPI 1538606348
-
- Pediatrics Physician
- Jackson, MI
- NPI 1891232740
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1619973229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 N JACKSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011266",
"telephone_number": "517-748-5500",
"fax_number": "517-780-9286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 N JACKSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011266",
"telephone_number": "517-748-5500",
"fax_number": "517-780-9286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSE",
"first_name": "SHARON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-28",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "5101014228",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4667950-11",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "srouse444805@direct.hfhs.org",
"affiliation": "N",
"address_1": "205 N East Ave",
"city": "Jackson",
"state": "MI",
"country_code": "US",
"postal_code": "492011753",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.