Individual provider Active NPI

Richard Andrew Rosebrock, NP

  • Gerontology Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1669860540
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
19225 Issued in SC
Practice address
101 E Wood St
Spartanburg, SC 29303-3040
Phone
(864) 560-6654
Fax
(864) 560-7353
NPI assigned
Dec 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 19225 SC
Nurse Practitioner 363L00000X 19225 SC
Gerontology Nurse Practitioner 363LG0600X 19225 SC Primary

Addresses

Primary practice location

101 E Wood St
Spartanburg, SC 29303-3040

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 1

IdentifierTypeStateIssuer
NP3030MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rrosebrock38581@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150303002338 SC Practitioner - Nurse Practitioner 6800112178 Reassigns benefits to 1 organization
I20250411001393 MA Practitioner - Nurse Practitioner 6800112178 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

275 Sandwich St
Plymouth, MA 02360-2183
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Aug 1, 2025 Accepting new patients
South Shore Medical Center, Inc. CurrentSince May 29, 2025 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 30, 2014 Accepting new patients
Spartanburg Regional Med Ctr CurrentSince Dec 30, 2014 Accepting new patients
Coastal Medical Associates CurrentSince May 29, 2025 Accepting new patients

Locations

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

141 Longwater Dr
Ste 201
Norwell, MA 02061
Phone (781) 261-7820

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

101 E Wood St
#300
Spartanburg, SC 29303

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Organizations & group practices 7

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 2

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": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1669860540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-6654",
            "fax_number": "864-560-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBROCK",
        "first_name": "RICHARD",
        "middle_name": "ANDREW",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-31",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "19225",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "19225",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "19225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3030",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rrosebrock38581@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rrosebrock38581@direct-srhs.et0939.epichosted.com",
            "address_1": "101 E Wood St",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.