Individual provider Active NPI

Amy Temple Rosenberger, RN, BSN

  • Family Nurse Practitioner
  • Elizabeth City, NC
National Provider Identifier
1710078159
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5013946 Issued in NC
Practice address
711 Roanoke Ave
Elizabeth City, NC 27909-5643
Phone
(252) 338-4400
Fax
(252) 338-4440
NPI assigned
Sep 28, 2006
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 183712 NC
Family Nurse Practitioner 363LF0000X 5013946 NC Primary

Addresses

Primary practice location

711 Roanoke Ave
Elizabeth City, NC 27909-5643

Mailing address

605 Bosley Rd
Sunbury, NC 27979-9601
Phone (252) 331-3269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210304002198 NC Practitioner - Nurse Practitioner 5193131852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

711 Roanoke Ave
Elizabeth City, NC 27909-5643
Phone (252) 338-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
183712NCMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Regional Health Services CurrentSince Feb 15, 2021 Accepting new patients
Albemarle Regional Health Services CurrentSince Feb 15, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

711 Roanoke Ave
Elizabeth Cty, NC 27909
Phone (252) 338-4370

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1710078159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 BOSLEY RD",
            "city": "SUNBURY",
            "state": "NC",
            "postal_code": "279799601",
            "telephone_number": "252-331-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ROANOKE AVE",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279095643",
            "telephone_number": "252-338-4400",
            "fax_number": "252-338-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERGER",
        "first_name": "AMY",
        "middle_name": "TEMPLE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NC",
            "license": "183712",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.