Individual provider Active NPI

Barbara Rose, AGPCNP

  • Primary Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1952799082
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP014219 Issued in PA
Practice address
650 Edison Ave
Philadelphia, PA 19116-1237
Phone
(215) 673-5700
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP014219 PA Primary

Addresses

Primary practice location

650 Edison Ave
Philadelphia, PA 19116-1237

Mailing address

2705 Dekalb Pike Ste 207
East Norriton, PA 19401-1852
Phone (844) 204-0005

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP014219PAMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: barbara.rose.1@17258.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1952799082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 DEKALB PIKE STE 207",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011852",
            "telephone_number": "844-204-0005",
            "fax_number": "484-322-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EDISON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161237",
            "telephone_number": "215-673-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "BARBARA",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP014219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.