Jennifer Nicole Rose, D.O.
Family Medicine in Lewisburg, WV. Individual provider (NPI-1).
NPI number1003175993
StatusActive
Last updated in NPPESSep 20, 2022
Details
- NPI
- 1003175993
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Nicole Rose
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 11, 2012
- Certification date
- Sep 20, 2022
- Last updated
- Sep 20, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2724 | WV | Yes |
Practice location
1464 Jefferson St NLewisburg, WV 24901-1380
Phone 304-645-3220 · Fax 844-479-4545
Mailing address
1464 Jefferson St NLewisburg, WV 24901-1380
Phone 304-645-3220 · Fax 844-479-4545
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 39 Family Medicine Physician providers in Lewisburg · All 647 providers in Lewisburg
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