Individual provider Active NPI

Emily R Rose

  • Family Nurse Practitioner
  • Richlands, VA
National Provider Identifier
1780228528
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178458 Issued in VA
Practice address
6719 Gov G.C. Peery Hwy
Richlands, VA 24641
Phone
(276) 596-6725
Fax
(276) 596-6726
NPI assigned
Nov 5, 2019
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178458 VA Primary
Family Medicine Physician 207Q00000X 0024178458 VA

Addresses

Primary practice location

6719 Gov G.C. Peery Hwy
Richlands, VA 24641

Mailing address

PO Box 273
Mavisdale, VA 24627-0273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200408003015 VA Practitioner - Nurse Practitioner 3476982786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 Cedar Valley Dr
Suite 3
Cedar Bluff, VA 24609-9247
Phone (276) 596-6449

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinch Professional Physician Services LLC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Clinch Professional Physician Services LLC CurrentSince Jan 1, 2022 Accepting new patients
St. Charles Health Council, Inc Past Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

1100 Cedar Valley Dr
Ste 3
Cedar Bluff, VA 24609
Phone (276) 596-6449

111 Fashion Rd
Ste D
Pounding Mill, VA 24637
Phone (276) 596-6375

6719 Governor Gc Peery Hwy
Ste 2450
Richlands, VA 24641
Phone (276) 596-6786

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1780228528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273",
            "city": "MAVISDALE",
            "state": "VA",
            "postal_code": "246270273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 GOV G.C. PEERY HWY",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "24641",
            "telephone_number": "276-596-6725",
            "fax_number": "276-596-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "EMILY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178458",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024178458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richlands, VA

Sources for this page

Verify at the official NPI Registry.