Skyler Wilson Rose

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Phone

(918) 207-0078

NPI assigned

Jun 8, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1639863822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SKYLER",
        "middle_name": "WILSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jena Sue Rogers, MD
• Libby Leininger Rogers, ARNP
• Markus Charles Rogers, DPT
• Dusty Rollice, PRSS
• Charles Edward Ronan, OD
• Cherika Ross
• Keri Ross
• Tracy L Ross, APN
• David Brent Rotton, DO, FACOS
• Brant Philip Rouse, D.D.S.

• Peer Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.