Rose Internal Medicine, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01054413A Issued in IN

Legal business name

ROSE INTERNAL MEDICINE, P.C.

Practice address

2205 W Sudbury Dr
Suite a
Bloomington, IN 47403-3737

Phone

(812) 961-1540

Fax

(812) 961-1535

NPI assigned

Nov 1, 2005

Organization subpart

No

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

Authorized official

Name

Becky Rose

Title

Office Manager

Phone

(812) 961-6961

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

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

Practitioners 1

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

• Charles Howard Rose, MD

  • Internal Medicine Physician
  • Bloomington, IN
  • NPI 1477544153
  Medicare reassignment NPD

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1992796718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W SUDBURY DR",
            "address_2": "SUITE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033737",
            "telephone_number": "812-961-1540",
            "fax_number": "812-961-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W SUDBURY DR",
            "address_2": "SUITE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033737",
            "telephone_number": "812-961-1540",
            "fax_number": "812-961-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE INTERNAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-961-6961"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01054413A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200513720A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD5526",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Anne Romashov, LMHC
• Yesenia Noemi Romo, H.A.D
• Maria Roncalli, MS
• Roo Home Care LLC
• Rooted ABA LLC
• Charles Howard Rose, MD
• Marabai Rose, LCSW
• Melody Rose
• Rebecca Ann Rose
• Sady Rose, RBT

• Internal Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.