Organization Active NPI

Roberta Edmundson Rose MD Inc

  • Durable Medical Equipment & Medical Supplies
  • Warsaw, IN
National Provider Identifier
1689899585
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
01029953A Issued in IN
Legal business name
ROBERTA EDMUNDSON ROSE MD INC
Practice address
800 E Center St
Warsaw, IN 46580-3325
Phone
(574) 269-5221
Fax
(574) 269-5580
NPI assigned
Apr 16, 2007
Organization subpart
Yes
Parent organization
ROBERTA EDMUNDSON ROSE M D INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Authorized official

Name
Roberta Edmundson Rose, M.D.
Title
President
Phone
(574) 269-5221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 01029953A IN Primary

Addresses

Primary practice location

800 E Center St
Warsaw, IN 46580-3325

Mailing address

PO Box 1222
Warsaw, IN 46581-1222
Phone (574) 269-5221

National Provider Directory

National Provider Directory
Part of
Roberta Edmundson Rose M D Inc

Locations

800 E Center St
Warsaw, IN 46580
Phone (574) 269-4090

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1689899585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1222",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465811222",
            "telephone_number": "574-269-5221",
            "fax_number": "574-269-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CENTER ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803325",
            "telephone_number": "574-269-5221",
            "fax_number": "574-269-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTA EDMUNDSON ROSE MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROBERTA EDMUNDSON ROSE M D INC",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "EDMUNDSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-269-5221",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "01029953A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.