Individual provider Active NPI

Jaclyn Rosario, MSN, APRN, FNP-BC

  • Nurse Practitioner
  • Cameron, NC
National Provider Identifier
1750153631
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023128263 Issued in NC
Practice address
84 Torrington RDG
Cameron, NC 28326-7991
Phone
(330) 205-4714
NPI assigned
Oct 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2023128263 NC Primary

Addresses

Primary practice location

84 Torrington RDG
Cameron, NC 28326-7991

Mailing address

84 Torrington RDG
Cameron, NC 28326-7991
Phone (330) 205-4714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112004376 NC Practitioner - Nurse Practitioner 4981056082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chma of NCGroup PAC ID 5092108605, 21 clinicians

Practice addresses (Care Compare)

6047 Tyvola Glen Cir
Suite 100
Charlotte, NC 28217-6431
Phone (443) 383-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023128263NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chma of NC CurrentSince Nov 27, 2023 Accepting new patients
Healing Partners Plus PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

6047 Tyvola Glen Cir
Charlotte, NC 28217
Phone (203) 238-7754

4037 E Independence Blvd
Ste 100
Charlotte, NC 28205
Phone (267) 239-6447

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1750153631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 TORRINGTON RDG",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283267991",
            "telephone_number": "330-205-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 TORRINGTON RDG",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283267991",
            "telephone_number": "330-205-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "JACLYN",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "2023128263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, NC

Sources for this page

Verify at the official NPI Registry.