STEPHANIE JENNIE RODDENBERRY (NPI# 1649772377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649772377 |
| Entity Type | Individual |
| Full Name | STEPHANIE JENNIE RODDENBERRY |
| Credential | APRN |
| Practice Address |
2301 S Fm 51 Ste 500 Decatur TX 76234 |
| Mailing Address |
2301 S Fm 51 Ste 500 Decatur TX 76234-3867 |
| Practice Telephone | 9406270013 |
| Practice Fax Number | 9406271900 |
| Mailing Telephone | 9406270013 |
| Mailing Fax Number | 9406271900 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP137613 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
9342824 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBSTX | 8KE822 | 01 |
| TX | 390412001 | 05 |
| Street Address |
2301 S FM 51 STE 500 |
| City | DECATUR |
| State | TX |
| Zip Code | 76234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| 1154518264 | Bryan James Dulock | Nurse Anesthetist, Certified Registered | 604 Medical Center Dr, Decatur, TX 76234 | 2007-10-02 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1790383776 | Angela Tope Adeleke | Nurse Practitioner | 3185 Georgian Woods Cir, Decatur, GA 30034-5105 | 2020-10-13 |
| 1417564147 | Jigna Patel | Nurse Practitioner | 1963 Don Juan Ln, Decatur, GA 30032-4218 | 2020-09-27 |
| 1659983856 | Emilie Carsell Mathias | Nurse Practitioner | 2208 N Crossing Way, Decatur, GA 30033-4175 | 2020-08-19 |
| 1275151078 | Tiffanie Marshall Mcguire | Nurse Practitioner | 2042 Beltline Rd Sw Ste B101, Decatur, AL 35601-5571 | 2020-07-08 |
| 1922623610 | Anastasiya A Drogoul | Nurse Practitioner | 2675 N Decatur Rd Ste 404, Decatur, GA 30033-6133 | 2020-06-09 |
| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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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.