Individual provider Active NPI

Christina M. Roscoe, RN

  • Registered Nurse
  • Lisle, IL
National Provider Identifier
1669704250
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.379953 Issued in IL
Practice address
4783 Lake Valley Dr
2D
Lisle, IL 60532-3705
Phone
(404) 547-8259
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN198196 GA
Registered Nurse 163W00000X 041.379953 IL Primary

Addresses

Primary practice location

4783 Lake Valley Dr
2D
Lisle, IL 60532-3705

Mailing address

4783 Lake Valley Dr
Apt#2D
Lisle, IL 60532-3705
Phone (404) 547-8259

Other names 1

  • Christina M. George Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN198196GAMDRegistered Nurse
041.379953ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1669704250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4783 LAKE VALLEY DR",
            "address_2": "APT#2D",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323705",
            "telephone_number": "404-547-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4783 LAKE VALLEY DR",
            "address_2": "2D",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323705",
            "telephone_number": "404-547-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSCOE",
        "first_name": "CHRISTINA",
        "middle_name": "M.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN198196",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.379953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "GEORGE",
            "middle_name": "M.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.