Active NPI
Kelly Roseman
- Specialist
- Cocoa, FL
National Provider Identifier
1942113394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 4896 Quarryside Dr
Cocoa, FL 32927-5965 - Phone
- (573) 680-7663
- NPI assigned
- Sep 25, 2026
- Last updated
- Sep 25, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
4896 Quarryside Dr
Cocoa, FL 32927-5965
Mailing address
4896 Quarryside Dr
Cocoa, FL 32927-5965
Phone (573) 680-7663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790294400000",
"number": "1942113394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4896 QUARRYSIDE DR",
"city": "COCOA",
"state": "FL",
"postal_code": "329275965",
"telephone_number": "573-680-7663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4896 QUARRYSIDE DR",
"city": "COCOA",
"state": "FL",
"postal_code": "329275965",
"telephone_number": "573-680-7663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEMAN",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.