Individual provider Active NPI

Dana R. Rosdahl, NP

  • Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1649353780
Registry record updated Sep 28, 2010
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN057911 Issued in AZ
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, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
718661MedicaidAZ

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. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN057911AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.