Individual provider Active NPI

Maryl Jean Rosser, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1790558534
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014658A Issued in IN
Practice address
3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147
Phone
(317) 291-7422
Fax
(317) 291-7433
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 71014658A IN Primary
Registered Nurse 163W00000X 28251318A IN

Addresses

Primary practice location

3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147

Mailing address

3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147
Phone (317) 291-7422

Other practice location 1

13345 Illinois St
Carmel, IN 46032-3318
Phone (317) 396-1300

Other practice location 2

5002 W 34th St Rm 604
Indianapolis, IN 46224-1519
Phone (317) 291-7422

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28251318AINMDRegistered Nurse
71014658AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Shalom Health Care Center, Inc. Past Accepting new patients
Shalom Health Care Center, Inc. Family Past Accepting new patients
Shalom Health Care Center, Inc. Family Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maryl.rosser.p1@direct.goodmancampbell.nextgenshare.com

Organizations & group practices 4

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": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1790558534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13345 Illinois St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460323318",
            "country_code": "US",
            "telephone_number": "317-396-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5002 W 34th St Rm 604",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462241519",
            "country_code": "US",
            "telephone_number": "317-291-7422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSER",
        "first_name": "MARYL",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014658A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28251318A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.