Carl Warren Rose, PA-C
Individual provider Active NPI Medical Physician Assistant · Westmoreland, TN
NPI 1740326495 · NPPES record last updated Aug 8, 2022
Key facts
- NPI
- 1740326495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA265 (TN)
- Practice address
- 12124 Highway 52 W Ste 5
Westmoreland, TN 37186-3257 - Phone
- (615) 644-3000
- Fax
- (615) 644-3076
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rose Family Clinic
Practice addresses (Care Compare)
12124 Hwy 52 W
Suite 5
Westmoreland, TN 37186-3257
Phone (615) 644-3000
PO Box
Suite 595
Westmoreland, TN 37186
Hospital & facility affiliations
- Adoration Home Health, LLC
- Homefirst of Middle Tennessee, LLC
- Highpoint Homecare
- Centerwell Home Health
- Macon Community Hospital
- Highpoint Health-Sumner With Ascension Saint Thoma
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120111000275 | TN | Practitioner - Physician Assistant | 9830366038 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KSC, Inc | Past | Accepting new patients |
Interoperability endpoints
- carl.rose.1@24545.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA265 | TN | Yes |
Addresses
Primary practice location
12124 Highway 52 W Ste 5
Westmoreland, TN 37186-3257
Mailing address
PO Box 595
Westmoreland, TN 37186-0595
Phone (615) 644-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3373426 | Medicaid | TN | |
| 4019704 | Other | TN | BLUE CROSS BLUE SHIELD |
Other providers in Westmoreland, TN
- Laura L Rice
- Rise and Bloom Counseling, PLLC
- Valerie A Ritchie
- Christine L. Rivest
- Rose Family Clinic
- Morgan Taylor Sadler
- Hunter Shrum
- Ann Elizabeth Silva
- Silver Angels of Tennessee - Sumner, LLC
- Kenedy McCade Sisson
All providers in Westmoreland, TN · Medical Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.