MR. ANDREW JUSTIN BAKER ROSE (NPI# 1770098139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770098139 |
| Entity Type | Individual |
| Full Name | MR. ANDREW JUSTIN BAKER ROSE |
| Credential | TCADC |
| Practice Address |
125 S Main Cross St Louisa KY 41230-1065 |
| Practice Telephone | 6066390938 |
| Practice Fax Number | 8598135394 |
| Mailing Telephone | 6066390938 |
| Mailing Fax Number | 8598135394 |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
175461 | KY | Behavioral Health & Social Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 113 Oak Ridge Ct, Prestonsburg, KY 416538607 | 6068891602 | 6062634467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750743159 | Andrew Charles Rose | Internal Medicine | 999 N 92nd St Ste 730, Milwaukee, WI 53226-4875 | 2016-03-24 |
| 1881663185 | Andrew N Rose | Physician Assistant | 1925 Whipple Ave # 30, Logandale, NV 89021 | 2006-03-17 |
| 1942864558 | Andrew Zhu Rose | Behavior Technician | 21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807 | 2019-04-29 |
| 1770916686 | Andrew Hinckley Rose | Social Worker | 91 Northwest Dr, Plainville, CT 06062-1534 | 2013-08-14 |
| 1053658930 | Andrew Newkirk Rose | Counselor | 3434 47th St, Suite 101, Boulder, CO 80301-1880 | 2013-01-11 |
| 1699046862 | Andrew Rose | Social Worker | 12555 Sw 1st St, Beaverton, OR 97005-0546 | 2012-01-19 |
| 1386961035 | Andrew M Rose | Counselor | 856 E Thompson Blvd, Ventura, CA 93001-2918 | 2010-04-20 |
| 1881823102 | Andrew Rose | Physical Therapist | 102 Irving Street, Nw, Washington, DC 20010 | 2009-07-08 |
| 1396998530 | Andrew Brent Rose | Pediatrics | 2301 House Ave, Suite 405, Cheyenne, WY 82001-3176 | 2008-10-31 |
| 1750591939 | Andrew Baldwin Rose | Internal Medicine | 9501 Roosevelt Blvd, Suite 501, Philadelphia, PA 19114-1025 | 2007-05-23 |
| Street Address |
125 S MAIN CROSS ST |
| City | LOUISA |
| State | KY |
| Zip Code | 41230-1065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154415594 | Amanda Slone | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2006-10-02 |
| 1124629282 | Brittany Baker | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-11-05 |
| 1750981296 | Ashlee Nicole Clemmons | Registered Nurse | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-26 |
| 1740889526 | Timothy Carter | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-22 |
| 1447858428 | Nancy Lynn Pelfrey | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-13 |
| 1104424183 | Carl Eugene Johnson IIi | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-13 |
| 1497352983 | Aquarius Dion Young | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-07 |
| 1760089254 | John Kevin Schmidt Jr. | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-07 |
| 1841897519 | Patrick Michael Fogarty | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-06 |
| 1942817622 | Seth Patrick Myers | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533599 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 105-107 E Madison St., Louisa, KY 41230 | 2019-11-18 |
| 1780236570 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 1640 Jerushia Branch Rd., Booneville, KY 41230 | 2019-07-11 |
| 1922528272 | Samantha Paige Stanley | Peer Specialist | 221 Windy Hill Drive, Louisa, KY 41230 | 2017-06-27 |
| 1407393457 | Chandra D Blevins | Peer Specialist | 125 N. Main Cross St., Louisa Office Addiction Recovery Care, Louisa, KY 41230 | 2017-01-30 |
| 1033654876 | Amanda Hurley | Peer Specialist | 125 N. Main Cross Street, Louisa, KY 41230 | 2017-01-04 |
| 1780127753 | Dakota Williams | Peer Specialist | 125 N Cross Main St, Louisa, KY 41230 | 2016-11-23 |
| 1568905529 | Tara Runyon | Peer Specialist | 125 N Main Cross Street, Louisa, KY 41230 | 2016-11-23 |
| 1134575624 | Misty Howell I | Peer Specialist | 125 S. Main Cross Street, Louisa, KY 41230 | 2016-05-13 |
| 1720404478 | Louisa Dental Care | Dentist | 203 S. Water St, Louisa, KY 41230 | 2014-03-05 |
| 1326336728 | Elite Chiropractic Psc | Chiropractor | 4347 Highway 2565, Louisa, KY 41230 | 2011-07-19 |
| Find all providers in zip 41230 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801247317 | Melissa Elliott | Case Manager/Care Coordinator | 4697 Highway 707, Louisa, KY 41230-7298 | 2016-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607605 | Yasmeen Barnes | Case Manager/Care Coordinator | 10207 Allentree Pl, Louisville, KY 40229-2214 | 2020-10-22 |
| 1669070348 | Ryan Bailey Meade | Case Manager/Care Coordinator | 1203 Greeting Card Road, Corbin, KY 40701-4811 | 2020-10-14 |
| 1669087466 | Sherry L Young | Case Manager/Care Coordinator | 72 Southland Dr, Somerset, KY 42501-6120 | 2020-09-09 |
| 1447863493 | Stacie Elizabeth Centers | Case Manager/Care Coordinator | 3212 Meeting Creek Rd, Eastview, KY 42732-9751 | 2020-08-28 |
| 1457963779 | Rebecca Erin Miller | Case Manager/Care Coordinator | 100 Francis St, Irvine, KY 40336-1018 | 2020-08-18 |
| 1952911190 | Arianne Riley | Case Manager/Care Coordinator | 418 W 9th St, Covington, KY 41011-2145 | 2020-08-03 |
| 1851914048 | Ryon Piphus | Case Manager/Care Coordinator | 1169 Eastern Pkwy Ste 336, Louisville, KY 40217-1417 | 2020-05-21 |
| 1518591908 | Sabrina Lee Stapp | Case Manager/Care Coordinator | 1500 Parkside Dr, Bowling Green, KY 42101-2756 | 2020-02-25 |
| 1801435524 | Virginia Carroll Shea | Case Manager/Care Coordinator | 1044 Rose Cir, Park Hills, KY 41011-1925 | 2019-12-27 |
| 1154969129 | Michelle Rae Hicks | Case Manager/Care Coordinator | 1151 S 4th St Ste 208, Louisville, KY 40203-3101 | 2019-12-20 |
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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.