Individual provider Active NPI

Katherine Julia Rose, APRN

  • Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1902424591
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
078560-23 Issued in NH
Practice address
1 Medical Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5529
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 078560-23 NH Primary

Addresses

Primary practice location

1 Medical Dr
Lebanon, NH 03756-0001

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200915001082 NH Practitioner - Nurse Practitioner 2961820501 Reassigns benefits to 2 organizations
I20240529002524 VT Practitioner - Nurse Practitioner 2961820501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

1080 Hospital Dr
St Johnsbury, VT 05819-6001
Phone (802) 473-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
078560-23NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 1, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Brattleboro Memorial Hospital PastSince Aug 1, 2016 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

1080 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 473-4100

Interoperability endpoints

  • Direct secure messaging: kpouliot384278@direct.dartmouth-hitchcock.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1902424591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KATHERINE",
        "middle_name": "JULIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "078560-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.