Individual provider Active NPI

John Allen Rose, RN, LMT

  • Massage Therapist
  • Winter Springs, FL
National Provider Identifier
1720421308
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA56728 Issued in FL
Practice address
2006 Town Plaza CT
Winter Springs, FL 32708-6216
Phone
(407) 590-6836
Fax
(407) 695-0069
NPI assigned
Apr 12, 2013
Last updated
Apr 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9330688 FL
Massage Therapist 225700000X MA56728 FL Primary

Addresses

Primary practice location

2006 Town Plaza CT
Winter Springs, FL 32708-6216

Mailing address

2006 Town Plaza CT
Winter Springs, FL 32708-6216
Phone (407) 590-6836

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9330688FLMDRegistered Nurse
MA56728FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1720421308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 TOWN PLAZA CT",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327086216",
            "telephone_number": "407-590-6836",
            "fax_number": "407-695-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 TOWN PLAZA CT",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327086216",
            "telephone_number": "407-590-6836",
            "fax_number": "407-695-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "credential": "RN, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9330688",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA56728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.