Individual provider Active NPI

Sara A Rosebaugh, CNP

  • Nurse Practitioner
  • Tallmadge, OH
National Provider Identifier
1790242121
Registry record updated Aug 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.024283 Issued in OH
Practice address
65 Community Rd Ste C
Tallmadge, OH 44278-2358
Phone
(330) 633-6601
Fax
(330) 644-9815
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2021

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 APRN.CNP.024283 OH Primary

Addresses

Primary practice location

65 Community Rd Ste C
Tallmadge, OH 44278-2358

Mailing address

65 Community Rd Ste C
Tallmadge, OH 44278-2358
Phone (330) 633-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190307000567 OH Practitioner - Nurse Practitioner 2163761222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Physicians Network IncGroup PAC ID 0648160002, 92 clinicians

Practice addresses (Care Compare)

3300 Greenwich Rd
Unit 8
Norton, OH 44203-5781
Phone (330) 825-7371

3515 Massillon Rd
Suite 300
Uniontown, OH 44685-7854

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Physicians Network, Inc. CurrentSince May 18, 2021 Accepting new patients
Pioneer Physicians Network Inc CurrentSince May 18, 2021 Accepting new patients
Radiology Associates of Canton, Inc. Past Accepting new patients

Locations

3515 Massillon Rd
Ste 300
Green, OH 44685
Phone (234) 271-3353

3300 Greenwich Rd
Unit 8
Norton, OH 44203
Phone (330) 825-7371

65 Community Rd
Tallmadge, OH 44278
Phone (330) 633-3680

65 Community Rd
Ste F
Tallmadge, OH 44278
Phone (330) 633-3680

65 Community Rd
Ste C
Tallmadge, OH 44278
Phone (330) 633-6601

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBBCAA
  • Direct secure messaging: sara.rosebaugh@ppn.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628294400000",
    "number": "1790242121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 COMMUNITY RD STE C",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782358",
            "telephone_number": "330-633-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 COMMUNITY RD STE C",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782358",
            "telephone_number": "330-633-6601",
            "fax_number": "330-644-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBAUGH",
        "first_name": "SARA",
        "middle_name": "A",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2021-08-07",
        "certification_date": "2021-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallmadge, OH

Sources for this page

Verify at the official NPI Registry.