MRS. DIANA TONG ROETTING (NPI# 1891036059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891036059 |
| Entity Type | Individual |
| Full Name | MRS. DIANA TONG ROETTING |
| Credential | PA-C |
| Practice Address |
130 Providence Rd Ste 100 Charlotte NC 28207-1242 |
| Mailing Address |
2952 Craftsman Ln Charlotte NC 28204-4392 |
| Practice Telephone | 7043339113 |
| Practice Fax Number | 7043339757 |
| Mailing Telephone | 5122969112 |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2014-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-04133 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
130 PROVIDENCE RD STE 100 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265522239 | Elizabeth Faircloth Rostan | Dermatology | 130 Providence Rd Ste 100, Charlotte, NC 28207-1242 | 2006-10-13 |
| 1326514787 | Chrystell Laura Cluck | Physician Assistant | 130 Providence Rd Ste 100, Charlotte, NC 28207-1247 | 2018-10-23 |
| 1538229737 | Charlotte Skin & Laser, P.a. | Specialist | 130 Providence Rd Ste 100, Charlotte, NC 28207-1242 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1417506791 | Lauren Moir | Physician Assistant | 2700 Coltsgate Rd Ste 106, Charlotte, NC 28211-3573 | 2019-09-09 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1285172981 | Melanie Reyer | Physician Assistant | 5005 Morrowick Rd, Charlotte, NC 28226-7366 | 2017-02-02 |
| 1255877627 | Taylor King | Physician Assistant | 730 Hawthorne Ln Apt 443, Charlotte, NC 28204-2182 | 2017-01-10 |
| 1831579242 | Lindsey Chaney Taylor | Physician Assistant | 1900 Randolph Road, Suite 900, Charlotte, NC 28207-1122 | 2015-06-02 |
| 1306232079 | Rebecca Lee Strunk-lail | Physician Assistant | 1211 N. Community House Rd, Charlotte, NC 28277 | 2015-04-09 |
| 1194117432 | Harlee Palmer | Physician Assistant | 10502 Park Rd Suite 100, Charlotte, NC 28210-8479 | 2015-02-24 |
| 1154669364 | Laura A Justen | Physician Assistant | 1025 Morehead Medical Dr Ste 225, Charlotte, NC 28204-2974 | 2013-01-23 |
| Find all providers in CHARLOTTE | ||||
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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.