Active NPI
George W. Roose II, PA-C
- Medical Physician Assistant
- Henderson, NV
National Provider Identifier
1891872180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 745
- Practice address
- 2904 W Horizon Ridge Pkwy
Ste 200
Henderson, NV 89052-5015 - Phone
- (702) 471-7779
- Fax
- (702) 471-0484
- NPI assigned
- Nov 1, 2006
- Last updated
- Sep 18, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 745 | NV | Primary |
Addresses
Primary practice location
2904 W Horizon Ridge Pkwy
Ste 200
Henderson, NV 89052-5015
Mailing address
PO Box 777550
Henderson, NV 89077-7550
Phone (702) 471-7779
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
| License | State | Type | Specialty |
|---|---|---|---|
| PA 745 | NV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premise Health of Nevada Medical Hinitt PC | Past | Accepting new patients | |
| Mohave Medical Oncology Center | Past | Accepting new patients | |
| Nutan K Parikh MD LTD Apc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Premise Health Wellness Center-Las Vegas
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- Las Vegas, NV
- NPI 1649977067
-
- Hematology & Oncology Physician
- Kingman, AZ
- NPI 1386834844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190073600000",
"number": "1891872180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 777550",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890777550",
"telephone_number": "702-471-7779",
"fax_number": "702-471-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 W HORIZON RIDGE PKWY",
"address_2": "STE 200",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525015",
"telephone_number": "702-471-7779",
"fax_number": "702-471-0484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSE",
"first_name": "GEORGE",
"middle_name": "W.",
"name_suffix": "II",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA 745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.