Active NPI
Jack William Rose, OTR/L
- Occupational Therapist
- Catonsville, MD
National Provider Identifier
1730005133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 07662
- Practice address
- 55 Wade Ave
Catonsville, MD 21228-4663 - Phone
- (410) 402-7166
- NPI assigned
- Jun 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 07662 | MD | Primary |
Addresses
Primary practice location
55 Wade Ave
Catonsville, MD 21228-4663
Mailing address
55 Wade Ave
White a- Rehab Office
Catonsville, MD 21228-4663
Phone (410) 402-7166
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1730005133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WADE AVE",
"address_2": "WHITE A- REHAB OFFICE",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212284663",
"telephone_number": "410-402-7166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WADE AVE",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212284663",
"telephone_number": "410-402-7166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JACK",
"middle_name": "WILLIAM",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-29",
"last_updated": "2026-06-29",
"certification_date": "2026-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "07662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Catonsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.