CAROLYN ANN RODERICK (NPI# 1548336258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548336258 |
| Entity Type | Individual |
| Full Name | CAROLYN ANN RODERICK |
| Other Name | CAROLYN ANN HEWKO |
| Credential | PHYSICIANS ASSISTANT |
| Practice Address |
170 Grandview Ave Waterbury CT 06708-2525 |
| Practice Telephone | 2037593666 |
| Practice Fax Number | 2037593671 |
| Mailing Telephone | 2037593666 |
| Mailing Fax Number | 2037593671 |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2017-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 001360 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004224490 | 05 | |
| CT | BLUE CROSS & BLUE SHIELD | 290001360CT05 | 01 |
| CT | HEALTHNET | 2V6845 | 01 |
| Street Address |
170 GRANDVIEW AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710904404 | Ann Lorraine Hume | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2006-07-17 |
| 1487033858 | Michelle Marie King | Registered Nurse | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2015-05-19 |
| 1669767059 | Jameel Uddeen | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2011-06-14 |
| 1912296419 | Jennifer Elizabeth Ouellette | Nurse Practitioner | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2011-04-05 |
| 1386951747 | Vanessa Yap | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2010-09-08 |
| 1508182965 | Sheila Jane Tan Zanoria | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708 | 2010-04-09 |
| 1053599902 | Ferdinando Urbano | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708 | 2008-02-02 |
| 1669501532 | Waterbury Pulmonary Associates | Internal Medicine | 170 Grandview Ave, Waterbury, CT 06708-2513 | 2007-03-05 |
| 1770695140 | Sandra J Dock | Physician Assistant | 170 Grandview Ave, Waterbury, CT 06708-2525 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| 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 |
|---|---|---|---|---|
| 1609481639 | Gresi Kello | Physician Assistant | 506 Frost Rd, Waterbury, CT 06705-2304 | 2020-09-15 |
| 1801446554 | George Ahyia Osae Jr. | Physician Assistant | 67 Buckland Dr, Waterbury, CT 06704 | 2019-09-16 |
| 1912495797 | Jennie Webb | Physician Assistant | 2247 E Main St Ste 103, Waterbury, CT 06705 | 2018-04-26 |
| 1003188814 | Jodi Lasky | Physician Assistant | 26 Westport Dr, Waterbury, CT 06706-2854 | 2012-02-09 |
| 1255668968 | Michele C Pierce | Physician Assistant | 60 Westwood Ave Ste 314, Waterbury, CT 06708-2460 | 2009-11-17 |
| 1700035615 | Marissa L Stankus | Physician Assistant | 171 Grandview Ave Ste 201, Waterbury, CT 06708-2520 | 2008-09-16 |
| 1588699557 | Adriane Guerin | Physician Assistant | 179 Roseland Ave, Waterbury, CT 06710 | 2006-07-11 |
| 1407826522 | Deanna Michaud | Physician Assistant | 2247 E Main St, Suite 103, Waterbury, CT 06705 | 2006-01-23 |
| 1891777918 | Alan Robert Houle | Physician Assistant | 1211 W Main St, Waterbury, CT 06708-3106 | 2005-11-15 |
| 1750389375 | Huma Tariq Khaliq | Physician Assistant | 232 N Elm St, Waterbury, CT 06702-1516 | 2005-07-08 |
| Find all providers in WATERBURY | ||||
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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.