Active NPI
Dana R. Rosdahl, NP
- Nurse Practitioner
- Chandler, AZ
National Provider Identifier
1649353780
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN057911
- Practice address
- 333 N Dobson Rd
Ste 16
Chandler, AZ 85224-4412 - Phone
- (480) 634-7833
- Fax
- (480) 275-5687
- NPI assigned
- Oct 23, 2006
- Last updated
- Sep 28, 2010
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN057911 | AZ | Primary |
Addresses
Primary practice location
333 N Dobson Rd
Ste 16
Chandler, AZ 85224-4412
Mailing address
333 N Dobson Rd
Ste 16
Chandler, AZ 85224-4412
Phone (480) 634-7833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 718661 | Medicaid | AZ |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN057911 | AZ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longlife Medical Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Point of Service
- Mesa, AZ
- NPI 1497975684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285632000000",
"number": "1649353780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N DOBSON RD",
"address_2": "STE 16",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852244412",
"telephone_number": "480-634-7833",
"fax_number": "480-275-5687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N DOBSON RD",
"address_2": "STE 16",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852244412",
"telephone_number": "480-634-7833",
"fax_number": "480-275-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSDAHL",
"first_name": "DANA",
"middle_name": "R.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2010-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "RN057911",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "718661",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.