NPIMap

Individual provider Active NPI

Robert M Rose, M.D.

  • Family Medicine Physician
  • King William, VA
National Provider Identifier
1730527342
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101259659 Issued in VA
Practice address
1041 Sharon Rd Ste 205
King William, VA 23086-3344
Phone
(804) 769-3096
Fax
(804) 769-3170
NPI assigned
Jun 6, 2013
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101259659 VA Primary

Addresses

Primary practice location

1041 Sharon Rd Ste 205
King William, VA 23086-3344

Mailing address

1041 Sharon Rd Ste 205
King William, VA 23086-3344
Phone (804) 769-3096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816002747 VA Practitioner - Family Practice 4981999885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7229 Forest Ave
Suite 112
Richmond, VA 23226-3765

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101259659VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours - Memorial Regional Medical Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Current Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Past Accepting new patients

Locations

1041 Sharon Rd
Ste 205
King William, VA 23086
Phone (804) 746-1677

4630 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444

Interoperability endpoints

  • Direct secure messaging: rrose1155199@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1730527342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 SHARON RD STE 205",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230863344",
            "telephone_number": "804-769-3096",
            "fax_number": "804-769-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 SHARON RD STE 205",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230863344",
            "telephone_number": "804-769-3096",
            "fax_number": "804-769-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101259659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King William, VA

Sources for this page

Verify at the official NPI Registry.