Active NPI
Lawrence S Rosen, MD
- Specialist
- Jacksonville, AL
National Provider Identifier
1629064118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 12000
- Practice address
- 201 Henry Rd SW
Jacksonville, AL 36265-3324 - Phone
- (256) 435-1871
- Fax
- (256) 435-5703
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 12000 | AL | Primary |
Addresses
Primary practice location
201 Henry Rd SW
Jacksonville, AL 36265-3324
Mailing address
PO Box 339
Jacksonville, AL 36265
Phone (256) 435-1871
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000014553 | Medicaid | AL |
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 Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1629064118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 339",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "36265",
"telephone_number": "256-435-1871",
"fax_number": "256-435-5703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 HENRY RD SW",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "362653324",
"telephone_number": "256-435-1871",
"fax_number": "256-435-5703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEN",
"first_name": "LAWRENCE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AL",
"license": "12000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000014553",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.