Active NPI
Carla M Rose, PA-C
- Physician Assistant
- North Canton, OH
National Provider Identifier
1851636575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.003603
- Practice address
- 6651 Frank Ave NW
North Canton, OH 44720 - Phone
- (330) 498-9865
- Fax
- (330) 498-9869
- NPI assigned
- Dec 6, 2012
- 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 | 50.003603 | OH | Primary |
Addresses
Primary practice location
6651 Frank Ave NW
North Canton, OH 44720
Mailing address
6651 Frank Ave NW
North Canton, OH 44720-8442
Phone (330) 498-9865
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.003603 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Valley Physicians Inc | Current | Accepting new patients |
Locations
936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600
Interoperability endpoints
- carla.rose@10522.chartlogic.direct-ci.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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1851636575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6651 FRANK AVE NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447208442",
"telephone_number": "330-498-9865",
"fax_number": "330-498-9869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6651 FRANK AVE NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "44720",
"telephone_number": "330-498-9865",
"fax_number": "330-498-9869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "CARLA",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-06",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.003603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.