MR. KELLY PATRICK ROSE (NPI# 1104044890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104044890 |
| Entity Type | Individual |
| Full Name | MR. KELLY PATRICK ROSE |
| Practice Address |
1333 Iris Ave Boulder CO 80304-2226 |
| Mailing Address |
960 Laramie Blvd Unit H Boulder CO 80304-4782 |
| Practice Telephone | 3034136233 |
| Mailing Telephone | 3032460487 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740728096 | Kelly Rose | Behavioral Analyst | 325 Teal Cres, Virginia Beach, VA 23456-4518 | 2017-02-07 |
| 1003170143 | Kelly Lee Rose | Marriage & Family Therapist | 3701 Shoreline Dr Ste 102a, 102a, Wayzata, MN 55391-4000 | 2012-07-03 |
| 1700955184 | Kelly L. Rose | Pathology | 1648 Pierce Dr, Suite 327, Atlanta, GA 30322-0001 | 2006-11-07 |
| 1932167145 | Kelly S Rose | Dentist | 1100 Main St, Buffalo, NY 14209-2308 | 2006-05-04 |
| 1811502891 | Kelly Rose | Speech-Language Pathologist | 65 Chapel St, Garnerville, NY 10923-1238 | 2020-09-15 |
| 1740824564 | Kelly Rose | Nurse Practitioner | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2019-11-05 |
| 1386119642 | Kelly Nicole Rose | Occupational Therapist | 100 Medical Center Pkwy Ste 100, Huntsville, TX 77340-4959 | 2018-10-12 |
| 1932627015 | Kelly Rose | Behavioral Analyst | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2017-09-08 |
| 1750789343 | Kelly Rose | Specialist/Technologist | 300 E College Ave, Salisbury, MD 21804-6599 | 2014-12-12 |
| 1558405449 | Kelly Rose | Psychologist | 318 E Basin Rd, New Castle, DE 19720-4214 | 2007-02-16 |
| Street Address |
1333 IRIS AVE |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982606521 | Karen Breunig Hine | Nurse Practitioner | 1333 Iris Ave, Boulder, CO 80304-2226 | 2005-08-12 |
| 1194209106 | Philippa Tucker | Student in an Organized Health Care Education/Training Program | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-09-17 |
| 1942781174 | Victoria Abbey | Counselor | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-08-26 |
| 1669966768 | Natalie Lamolinara | Counselor | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-06-21 |
| 1285126854 | Jennifer Egloff | Social Worker | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-05-30 |
| 1790276624 | Johanna B Grube | Student in an Organized Health Care Education/Training Program | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-05-26 |
| 1578053930 | Leane Marie Vasquez | Peer Specialist | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-05-11 |
| 1730678749 | Jennifer Cullom | Counselor | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-05-04 |
| 1366931735 | Amanda Cantu | Counselor | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-05-01 |
| 1679060545 | Purnima Jagtap | Social Worker | 1333 Iris Ave, Boulder, CO 80304-2226 | 2018-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558107 | Alec Farbman | Counselor | 1941 Pearl St Unit 202, Boulder, CO 80302-4467 | 2020-11-08 |
| 1942801378 | Chloe Sari Koeffler | Counselor | 2919 Valmont Rd Ste 209, Boulder, CO 80301-1350 | 2020-11-03 |
| 1114527660 | Anneva Noelle Knapp Garner | Counselor | 3363 Hickok Pl, Boulder, CO 80301-1984 | 2020-10-26 |
| 1215535828 | Emily Forse | Counselor | 1501 Yarmouth Ave Unit C-18, Boulder, CO 80304-0564 | 2020-10-15 |
| 1174121875 | Chris Cannon | Counselor | 3450 Hayden Pl Apt 3, Boulder, CO 80301-1929 | 2020-10-14 |
| 1992303911 | Riese Rose | Counselor | 4478 Hamilton Ct, Boulder, CO 80305-5554 | 2020-10-12 |
| 1477151728 | Karina Maria Tibble | Counselor | 5378 Sterling Dr # 1, Boulder, CO 80301-2351 | 2020-10-09 |
| 1902403538 | Brianna Kaylin Jones | Counselor | 2024 Goss St Apt 5, Boulder, CO 80302-6577 | 2020-10-06 |
| 1063029510 | Ryan O'millian | Counselor | 2919 Valmont Rd Ste 206, Boulder, CO 80301-1350 | 2020-09-29 |
| 1073123691 | Corinne Schuele | Counselor | 2299 Pearl St Ste 400a, Boulder, CO 80302-4673 | 2020-08-07 |
| Find all providers in BOULDER | ||||
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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.