Individual provider Active NPI

Kelly Rosenbeck, APRN, FNP-C

  • Family Nurse Practitioner
  • Newport, RI
National Provider Identifier
1659053577
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN03775 Issued in RI
Practice address
20 Powel Ave
Newport, RI 02840
Phone
(401) 845-1190
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN55340 RI
Family Nurse Practitioner 363LF0000X APRN03775 RI Primary

Addresses

Primary practice location

20 Powel Ave
Newport, RI 02840

Mailing address

11 Earl Ave
Newport, RI 02840-4021
Phone (413) 949-0049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208003281 RI Practitioner - Nurse Practitioner 8628427135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Newport HospitalGroup PAC ID 0042111437, 42 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

11 Friendship St
Newport, RI 02840-2209
Phone (401) 845-1110

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN55340RIMDMedical-Surgical Registered Nurse
APRN03775RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Hospital Family CurrentSince Oct 31, 2023 Accepting new patients
Lifespan Physician Group, Inc. Family CurrentSince May 1, 2024 Accepting new patients
Newport Hospital CurrentSince Oct 31, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince May 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
#7
Providence, RI 02903
Phone (401) 444-3565

593 Eddy St
#6
Providence, RI 02903
Phone (401) 793-9166

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1659053577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EARL AVE",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028404021",
            "telephone_number": "413-949-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POWEL AVE",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "02840",
            "telephone_number": "401-845-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBECK",
        "first_name": "KELLY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "RI",
            "license": "RN55340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.