Individual provider Active NPI

Stephanie Lynn Roeser, LPN

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1639838212
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN102285MEDS Issued in OH
Practice address
2594 Bulen Ave
Columbus, OH 43207-2720
Phone
(614) 633-7790
NPI assigned
Dec 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN102285MEDS OH Primary

Addresses

Primary practice location

2594 Bulen Ave
Columbus, OH 43207-2720

Mailing address

2594 Bulen Ave
Columbus, OH 43207-2720
Phone (614) 633-7790

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN102285MEDSOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1639838212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2594 BULEN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432072720",
            "telephone_number": "614-633-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2594 BULEN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432072720",
            "telephone_number": "614-633-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESER",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN102285MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.