Active NPI
Kimberly Jean Rose, P.A.
- Physician Assistant
- La Follette, TN
National Provider Identifier
1851610356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1795
- Practice address
- 923 E Central Ave
La Follette, TN 37766-2768 - Phone
- (423) 907-1404
- Fax
- (423) 907-1160
- NPI assigned
- May 24, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1795 | TN | Primary |
Addresses
Primary practice location
923 E Central Ave
La Follette, TN 37766-2768
Mailing address
1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1795 | TN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Kentucky, PLLC | Past | Accepting new patients | |
| Cane Ridge Emergency Physicians LLC | Past | Accepting new patients | |
| Afc Urgent Care and Family Care of WNC, PLLC | Past | Accepting new patients | |
| Sparrow Emergency Physicians PLLC | Physician Assistant | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Smyrna, TN
- NPI 1275815433
-
- Emergency Medicine Physician
- Knoxville, TN
- NPI 1225408339
Physician Assistant
-
dba Afc Urgent Care
- Urgent Care Clinic/Center
- Charlotte, NC
- NPI 1679066658
-
- Anesthesiology Physician
- Louisville, KY
- NPI 1386938900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297036800000",
"number": "1851610356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 CENTERPOINT BLVD",
"address_2": "SUITE 100",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379321984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 E CENTRAL AVE",
"city": "LA FOLLETTE",
"state": "TN",
"postal_code": "377662768",
"telephone_number": "423-907-1404",
"fax_number": "423-907-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-24",
"last_updated": "2011-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "1795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Follette, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.