Active NPI
Jessica H Rose, RN
- General Practice Registered Nurse
- Vail, AZ
National Provider Identifier
1861028581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 148950
- Practice address
- 584 E Blue Rock Way
Vail, AZ 85641-2270 - Phone
- (813) 451-9254
- NPI assigned
- Mar 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 148950 | AZ | Primary |
Addresses
Primary practice location
584 E Blue Rock Way
Vail, AZ 85641-2270
Mailing address
584 E Blue Rock Way
Vail, AZ 85641-2270
Phone (813) 451-9254
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148950 | Other | AZ | LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | VAIL | Direct | |
| CONNECT URL | VAIL | Direct |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148950 | AZ | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584057600000",
"number": "1861028581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "584 E BLUE ROCK WAY",
"city": "VAIL",
"state": "AZ",
"postal_code": "856412270",
"telephone_number": "813-451-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "584 E BLUE ROCK WAY",
"city": "VAIL",
"state": "AZ",
"postal_code": "856412270",
"telephone_number": "813-451-9254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JESSICA",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-13",
"last_updated": "2020-03-13",
"certification_date": "2020-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "AZ",
"license": "148950",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "148950",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "VAIL",
"affiliation": "N",
"endpointDescription": "home",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "584 E Blue Rock Way",
"city": "Vail",
"state": "AZ",
"country_code": "US",
"postal_code": "856412270",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "VAIL",
"affiliation": "N",
"endpointDescription": "home",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "584 E Blue Rock Way",
"city": "Vail",
"state": "AZ",
"country_code": "US",
"postal_code": "856412270",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Vail, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.