Individual provider Active NPI

Charles Edward Rose Jr., M.D.

  • Pulmonary Disease Physician
  • Charlottesville, VA
National Provider Identifier
1649291303
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101031391 Issued in VA
Practice address
1221 Lee St
Charlottesville, VA 22908-0001
Phone
(434) 924-5219
Fax
(434) 244-7509
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0101031391 VA Primary

Addresses

Primary practice location

1221 Lee St
Charlottesville, VA 22908-0001

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other identifiers 1

IdentifierTypeStateIssuer
1649291303MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crose6838@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060329000637 VA Practitioner - Critical Care (Intensivists) 9931117108 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jun 30, 1981 Accepting new patients

Locations

1221 Lee St
Charlottesville, VA 22908

5 Hospital Dr
Charlottesville, VA 22908
Phone (434) 924-5219

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: charles.rose.1@20955.direct.athenahealth.com
  • Direct secure messaging: crose6838@direct.healthsystem.virginia.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1649291303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-5219",
            "fax_number": "434-244-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101031391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649291303",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crose6838@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1221 Lee St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.