Individual provider Active NPI

Rose McCarthy

  • Gerontology Registered Nurse
  • San Rafael, CA
National Provider Identifier
1891169355
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
243726 Issued in CA
Practice address
16 Angelica CT
San Rafael, CA 94901-1327
Phone
(415) 717-3896
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 243726 CA Primary
Gerontology Nurse Practitioner 363LG0600X 4080 CA

Addresses

Primary practice location

16 Angelica CT
San Rafael, CA 94901-1327

Mailing address

16 Angelica CT
San Rafael, CA 94901-1327
Phone (415) 717-3896

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

State licenses

LicenseStateTypeSpecialty
243726CAMDGerontology Registered Nurse
4080CAMDAudiologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1891169355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ANGELICA CT",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011327",
            "telephone_number": "415-717-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ANGELICA CT",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011327",
            "telephone_number": "415-717-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CA",
            "license": "243726",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "4080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.