Jenny Rose Specialized Therapy Center LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC005819 Issued in PA

Legal business name

JENNY ROSE SPECIALIZED THERAPY CENTER LLC

Practice address

296 E Brown St
Suite B
East Stroudsburg, PA 18301-3011

Phone

(570) 421-3415

Fax

(570) 421-9873

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Elaine R Parker, CHT

Title

Director/Owner

Phone

(570) 421-3415

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1720260904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 E BROWN ST",
            "address_2": "SUITE B",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013011",
            "telephone_number": "570-421-3415",
            "fax_number": "570-421-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 E BROWN ST",
            "address_2": "SUITE B",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013011",
            "telephone_number": "570-421-3415",
            "fax_number": "570-421-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNY ROSE SPECIALIZED THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "570-421-3415",
        "authorized_official_credential": "CHT"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC005819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018703100005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018703100004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pavel Jaworski, PA-C
• Roodline Jean-Baptiste, MD
• Chloe Armani Jeanlouis
• Jennife Ryoung, PH.D.
• Jenny Rose Specialized Therapy Center LLC
• Joel Paradis
• Charlene V Johnson, CRNA
• Cherron E Johnson, PA-C
• Drew Elizabeth Johnson, ATC
• Katlyn Johnson

• Foot & Ankle Surgery Podiatrist in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

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