Individual provider Active NPI

John Joseph Rose Jr., PHARMD

  • Pharmacist
  • Redding, CA
National Provider Identifier
1699043521
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66667 Issued in CA
Practice address
1280 Dana Dr
T-0615
Redding, CA 96003-4038
Phone
(530) 224-1437
Fax
(530) 224-1437
NPI assigned
Dec 6, 2011
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66667 CA Primary

Addresses

Primary practice location

1280 Dana Dr
T-0615
Redding, CA 96003-4038

Mailing address

1280 Dana Dr
T-0615
Redding, CA 96003-4038
Phone (530) 224-1437

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
66667CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1699043521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 DANA DR",
            "address_2": "T-0615",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034038",
            "telephone_number": "530-224-1437",
            "fax_number": "530-224-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 DANA DR",
            "address_2": "T-0615",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034038",
            "telephone_number": "530-224-1437",
            "fax_number": "530-224-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.