Individual provider Active NPI

Jennifer Ray Rosenbaum, LMP

  • Specialist
  • Woodland, WA
National Provider Identifier
1801345475
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60607972 Issued in WA
Practice address
321 Forest Park Rd
Woodland, WA 98674-7204
Phone
(360) 721-6321
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60607972 WA Primary

Addresses

Primary practice location

321 Forest Park Rd
Woodland, WA 98674-7204

Mailing address

321 Forest Park Rd
Woodland, WA 98674-7204
Phone (360) 721-6321

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)
Not enrolled
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
MA60607972WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Choice Chiropractic PC, Inc. PastSince Mar 24, 2011 Accepting new patients

Organizations & group practices 1

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1801345475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FOREST PARK RD",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986747204",
            "telephone_number": "360-721-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 FOREST PARK RD",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986747204",
            "telephone_number": "360-721-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "JENNIFER",
        "middle_name": "RAY",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60607972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.