JEROME ROSE (NPI# 1093133092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093133092 |
| Entity Type | Individual |
| Full Name | JEROME ROSE |
| Credential | RT |
| Practice Address |
167 North Main Street Tuba City AZ 86045-0600 |
| Mailing Address |
Po Box 600 Tuba City AZ 86045-0600 |
| Practice Telephone | 9282832501 |
| Mailing Telephone | 9282832781 |
| Mailing Fax Number | 9282832677 |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | 521689 | AZ | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
167 NORTH MAIN STREET |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045-0600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912906645 | Thomas Joseph Peters | Orthopaedic Surgery | 167 North Main Street, Tuba City, AZ 86045-0600 | 2005-07-15 |
| 1134696412 | Young Chou | Pharmacist | 167 North Main Street, Tuba City, AZ 86045 | 2018-10-25 |
| 1447736186 | Kenneth Hale | Dentist | 167 North Main Street, Tuba City, AZ 86045 | 2018-07-16 |
| 1659868024 | Bradley Hilken | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2018-04-20 |
| 1811484314 | Elizabeth Sullivan | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1093217945 | Scott Cerreta | Respiratory Therapist, Registered | 167 North Main Street, Po Box 600, Tuba City, AZ 86045-0600 | 2018-03-07 |
| 1821502287 | Rachel Dye | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-21 |
| 1467965319 | Amber Vaughn | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-14 |
| 1639682701 | Roselita Sloan | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-13 |
| 1306359518 | Debra Marshall | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679991749 | Heather Ann Lemons | Radiologic Technologist | 167 Noth Main Street, Tuba City, AZ 86045-0600 | 2014-04-04 |
| 1811484314 | Elizabeth Sullivan | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1992292486 | Joe Collucci | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1811484306 | Shyanne Lomayaktewa | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1235626714 | Pearlena Beyal | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1043630486 | Kimberly A Harn | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2014-04-24 |
| 1972935237 | Shane Leon Tryon | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2013-08-08 |
| 1790123693 | Christopher Paul Edger | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2013-06-13 |
| 1548507379 | David G.l. Williams | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2013-01-14 |
| 1205188398 | Ernesto Marrero Jr. | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2012-10-12 |
| Find all providers in TUBA CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.