MYRON RODDENBERRY (NPI# 1346245040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346245040 |
| Entity Type | Individual |
| Full Name | MYRON RODDENBERRY |
| Credential | PA |
| Practice Address |
200 Medical Park Dr Suite 230 Concord NC 28025-2982 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7044031349 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2019-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 101195 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Blythe Blvd, Ste 300 - Adult Cardiology, Charlotte, NC 282035866 | 7043730212 | |
| 10650 Park Rd, Suite 220, Charlotte, NC 282108538 | 7046673840 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044461242 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044461255 |
| Street Address |
200 MEDICAL PARK DR SUITE 230 |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679183776 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 200 Medical Park Dr, Ste 500, Concord, NC 28025-2982 | 2020-08-04 |
| 1518577832 | Leah Mccain | Nurse Practitioner | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2020-08-01 |
| 1477198091 | Ryan Cannici | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2019-11-07 |
| 1881159341 | Jessica Surane | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2019-02-08 |
| 1740756253 | Samantha Mason | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-10-23 |
| 1700361466 | Montana Poe | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-09-28 |
| 1932695574 | Stephanie White | Nurse Practitioner | 200 Medical Park Dr, Ste 430, Concord, NC 28025-2982 | 2018-07-06 |
| 1487185534 | Mukunda Singh | Internal Medicine | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2017-03-21 |
| 1497207641 | Jessica Marchal | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2016-11-03 |
| 1619423712 | Brian Yorke | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2016-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455116 | Catherine Elizabeth O'neill | Physician Assistant | 4397 Arrowwood Cir, Concord, CA 94521-4428 | 2020-10-22 |
| 1972112084 | Claire Thetford | Physician Assistant | 9859 Flower Bonnet Ave Nw, Concord, NC 28027-8230 | 2020-07-24 |
| 1497379770 | Jacqueline Watts | Physician Assistant | 45 Garrison Rd, Concord, MA 01742-1926 | 2020-06-03 |
| 1063050870 | Kathryn Taylor Dudoroff | Physician Assistant | 5374 Myrtle Dr, Concord, CA 94521-1519 | 2019-12-12 |
| 1841833449 | Jennifer Lau | Physician Assistant | 4397 N Spoonwood Ct, Concord, CA 94521-4305 | 2019-10-26 |
| 1972072122 | Rocio Flores Neale | Physician Assistant | 2415 High School Avenue, Suite 800, Concord, CA 94520 | 2018-11-16 |
| 1598232134 | Catherine Valerie Hickey | Physician Assistant | 4040 Cowell Rd, Concord, CA 94518-1711 | 2018-11-01 |
| 1316422876 | Brendan Kyle Lucas | Physician Assistant | 2332 Fairfield Ave, Concord, CA 94520-1912 | 2018-10-01 |
| 1760999510 | Padmaja Shyamala Murtinty | Physician Assistant | 780 Oak Grove Rd Apt D119, Concord, CA 94518-2772 | 2018-01-02 |
| 1538672068 | Michelle Jaclyn Garcia | Physician Assistant | 1855 Gateway Blvd Ste 100, Concord, CA 94520 | 2017-11-06 |
| Find all providers in CONCORD | ||||
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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.