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1588238331 NPI number — JOHN GABRIEL ROLSHOVEN MD

NPI Number: 1588238331
Health Care Provider/Practitioner: JOHN GABRIEL ROLSHOVEN MD

Information about “1588238331” NPI (JOHN GABRIEL ROLSHOVEN MD) exists in 1588238331 in HTML format HTML  |  1588238331 in plain Text format TXT  |  1588238331 in PDF (Portable Document Format) PDF  |  1588238331 in an XML format XML  formats.

NPI Number : 1588238331 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1588238331",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROLSHOVEN",
    "FirstName": "JOHN",
    "MiddleName": "GABRIEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROLSHOVEN",
    "OtherFirstName": "JOHN",
    "OtherMiddleName": "GABRIEL KUNCHEFF",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2385 E PRATER WAY STE 205",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPARKS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89434-9688",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "775-356-4888",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2385 E PRATER WAY STE 205",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPARKS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89434-9688",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "775-356-4888",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/17/2021",
    "LastUpdateDate": "10/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207P00000X",
          "TaxonomyName": "Emergency Medicine Physician",
          "LicenseNumber": "27781",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207PS0010X",
          "TaxonomyName": "Sports Medicine (Emergency Medicine) Physician",
          "LicenseNumber": "27781",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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