Rosenberg Initiative

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROSENBERG INITIATIVE

Practice address

929 Vincent Way
Las Vegas, NV 89145-6105

Phone

(702) 468-2686

Fax

(702) 852-0441

NPI assigned

Mar 7, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Brandon S Line

Title

Chief Operations Officer

Phone

(702) 232-0833

Specialties & licenses 1

Addresses

Other names 1

• Rosenberg Initiative Clinic on Wheels Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeanette Rebecca Rosenberg-Line, APRN

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1548986813
  Medicare reassignment

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1912765736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46682",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891146682",
            "telephone_number": "702-468-2686",
            "fax_number": "702-852-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 VINCENT WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456105",
            "telephone_number": "702-468-2686",
            "fax_number": "702-852-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSENBERG INITIATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "LINE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "702-232-0833",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosenberg Initiative Clinic on Wheels",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Rosen
• Robert Scott Rosen, M.D.
• Stephanie Taylor Rosen, DPT
• Amy Ann Rosenbaum, DO
• Jennette Rosenbaum
• Jeanette Rebecca Rosenberg-Line, APRN
• Johanna Rosenberg
• Joshua Rosenberg, DO
• Lindsey Rosenberg, APRN-FNP-C
• Lisa Rosenberg

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.