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ROSE INTERNAL MEDICINE P.C. NPI 1992796718


NPI Information

NPI: 1992796718
Provider Name: ROSE INTERNAL MEDICINE, P.C.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 15D1039614

Address:
2205 W SUDBURY DR
SUITE A
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 961-1540
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ROSE INTERNAL MEDICINE, P.C. is an internal medicine in Bloomington, IN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. ROSE INTERNAL MEDICINE, P.C. NPI is 1992796718. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2205 W SUDBURY DR
SUITE A
BLOOMINGTON, IN
ZIP 47403-737
Phone: (812) 961-1540
Fax: (812) 961-1535

The provider's authorized official is Becky Rose .
The authorized official title is Office Manager and has the following contact phone number (812) 961-6961.

The CLIA number assigned to this NPI record is 15D1039614 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2005 and was last updated on 9/22/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine01054413AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H58102MEDICARE UPININDIANA
2200513720AMEDICAIDINDIANA
3DD5526OTHERINDIANARAILROAD MEDICARE
4225960MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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