Individual provider Active NPI

Marianne Way Rosen, M.D.

  • Dermatology Physician
  • Charleston, SC
National Provider Identifier
1801907936
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
12888 Issued in SC
Practice address
776 Daniel Ellis Dr
Unit 1 a
Charleston, SC 29412-3094
Phone
(843) 723-6529
Fax
(843) 723-0424
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 12888 SC Primary

Addresses

Primary practice location

776 Daniel Ellis Dr
Unit 1 a
Charleston, SC 29412-3094

Mailing address

776 Daniel Ellis Dr
Unit 1 a
Charleston, SC 29412-3094
Phone (843) 723-6529

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

LicenseStateTypeSpecialty
12888SCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marianne W Rosen, M.D. Dermatology PastSince Nov 14, 2004 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1801907936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DR",
            "address_2": "UNIT 1 A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123094",
            "telephone_number": "843-723-6529",
            "fax_number": "843-723-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DR",
            "address_2": "UNIT 1 A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123094",
            "telephone_number": "843-723-6529",
            "fax_number": "843-723-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MARIANNE",
        "middle_name": "WAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "12888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.