Individual provider Active NPI

Rachel M Rose, PA-C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1912675422
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13967841-1206 Issued in UT
Practice address
4650 Harrison Blvd
Ogden, UT 84403-4303
Phone
(801) 475-3010
Fax
(801) 475-3001
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13967841-1206 UT Primary

Addresses

Primary practice location

4650 Harrison Blvd
Ogden, UT 84403-4303

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250207002561 UT Practitioner - Physician Assistant 2769888270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3010

4700 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3010

5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100

6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Physician Assistant Current Accepting new patients

Locations

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1912675422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500",
            "fax_number": "801-475-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3010",
            "fax_number": "801-475-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "RACHEL",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13967841-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.