Active NPI
Rosetta Lakes
- Nurse Practitioner
- Manchester, KY
National Provider Identifier
1881733111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1037165
- Practice address
- 100 S Court St
Manchester, KY 40962-1295 - Phone
- (606) 598-2425
- Fax
- (606) 598-4448
- NPI assigned
- Feb 5, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1037165 | KY | Primary |
Addresses
Primary practice location
100 S Court St
Manchester, KY 40962-1295
Mailing address
PO Box 158
Manchester Square Shopping Ctr. Room 212
Manchester, KY 40962-0158
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1037165 | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Valley District Health Department | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Public Health or Welfare Agency
- Manchester, KY
- NPI 1669514923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881733111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"address_2": "MANCHESTER SQUARE SHOPPING CTR. ROOM 212",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409620158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S COURT ST",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409621295",
"telephone_number": "606-598-2425",
"fax_number": "606-598-4448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKES",
"first_name": "ROSETTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "1037165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, KY
- Keerthana Kalengada Karumbaiah
- Kentucky Medical Investors, LLC (Laurel Creek Health Care Center)
- Kishore Internal Medicine
- Kishore Internal Medicine, PSC
- L.a. Medical Supply, Inc.
- Landmark of Laurel Creek Rehabilitation and Nursing Center
- Amanda M Langdon, OTRL
- Mariah Kate Langdon, LCSW
- Laurel Creek Healthcare and Rehabilitation Center LLC (Laurel Creek Healthcare and Rehabilitation Center)
- Laurel Creek Post Acute LLC (Laurel Creek Post Acute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.