Individual provider Active NPI

Rosha L Landry, RN, MSSW

  • Social Worker
  • Milwaukee, WI
National Provider Identifier
1740442177
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
126508-121 Issued in WI
Practice address
2266 N Prospect Ave
Ste 616
Milwaukee, WI 53202-6319
Phone
(414) 289-0987
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 126508-121 WI Primary

Addresses

Primary practice location

2266 N Prospect Ave
Ste 616
Milwaukee, WI 53202-6319

Mailing address

2266 N Prospect Ave
Ste 616
Milwaukee, WI 53202-6319
Phone (414) 289-0987

Other identifiers 1

IdentifierTypeStateIssuer
41002600MedicaidWI

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
126508-121WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1740442177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 N PROSPECT AVE",
            "address_2": "STE 616",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026319",
            "telephone_number": "414-289-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N PROSPECT AVE",
            "address_2": "STE 616",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026319",
            "telephone_number": "414-289-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "ROSHA",
        "middle_name": "L",
        "credential": "RN, MSSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "126508-121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41002600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.