Scotty R Rose, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

624 Issued in WV

Practice address

101 S Eisenhower Dr
Beckley, WV 25801-4929

Phone

(304) 256-7100

Fax

(304) 256-7111

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• FMRS Health Systems Inc

  • Community/Behavioral Health Agency
  • Beckley, WV
  • NPI 1881733616
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1780627885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7100",
            "fax_number": "304-256-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7100",
            "fax_number": "304-256-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SCOTTY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780627885",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Belinda Sue Rose
• Brady Rose
• Kristina Rose
• Nellie Sue Rose, LMT
• Paul Todd Rose, D.D.S.
• Whitney Rose, CRNP
• Tina Roseblock
• Sydney Rancer Rosenberg
• Derek Ross, D.D.S.
• Heather A Ross

• Physician Assistant in Beckley, WV
• Providers in Beckley, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.