Active NPI
Jerry L Rozeboom, MD
- Obstetrics & Gynecology Physician
- Cedar Rapids, IA
National Provider Identifier
1780688325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 25841
- Practice address
- 855 A Ave NE
Cedar Rapids, IA 52402-5057 - Phone
- (319) 368-5500
- Fax
- (319) 368-5503
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 25841 | IA | Primary |
Addresses
Primary practice location
855 A Ave NE
Cedar Rapids, IA 52402-5057
Mailing address
855 A Ave NE
P O Box 3080
Cedar Rapids, IA 52406-3080
Phone (319) 368-5500
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25841 | IA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321660800000",
"number": "1780688325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 A AVE NE",
"address_2": "P O BOX 3080",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524063080",
"telephone_number": "319-368-5500",
"fax_number": "319-368-5503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 A AVE NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025057",
"telephone_number": "319-368-5500",
"fax_number": "319-368-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZEBOOM",
"first_name": "JERRY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2011-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IA",
"license": "25841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.