Individual provider Active NPI

Stephanie L Rose, MS, ATC

  • Athletic Trainer
  • Dunkirk, NY
National Provider Identifier
1710339056
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
003173 Issued in NY
Practice address
419 Central Avenue
Dunkirk, NY 14048
Phone
(716) 672-2000
Fax
(716) 363-2172
NPI assigned
Jul 11, 2016
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 003173 NY Primary
Athletic Trainer 2255A2300X 3173 NY

Addresses

Primary practice location

419 Central Avenue
Dunkirk, NY 14048

Mailing address

99 Lake Ave
Brocton, NY 14716-9755

Other names 1

  • Ms. Stephanie L Woleben 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
Master of Science

State licenses

LicenseStateTypeSpecialty
003173NYMDAddiction (Substance Use Disorder) Counselor
3173NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC PastSince Aug 10, 2025 Accepting new patients
Lake Erie Medical Services, PC PastSince Aug 10, 2025 Accepting new patients

Organizations & group practices 2

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1710339056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 LAKE AVE",
            "city": "BROCTON",
            "state": "NY",
            "postal_code": "147169755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 CENTRAL AVENUE",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "14048",
            "telephone_number": "716-672-2000",
            "fax_number": "716-363-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003173",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "3173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WOLEBEN",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.