DR. RODERIC JOEL HARTMAN (NPI# 1962607317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962607317 |
| Entity Type | Individual |
| Full Name | DR. RODERIC JOEL HARTMAN |
| Credential | M.D. |
| Practice Address |
1896 E Babbitt Lane San Luis AZ 85349-1669 |
| Mailing Address |
Po Box 1669 1896 E Babbitt Lane San Luis AZ 85349-1669 |
| Practice Telephone | 9287226112 |
| Practice Fax Number | 9287226113 |
| Mailing Telephone | 9287226112 |
| Mailing Fax Number | 9287226113 |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2016-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 21315 | AZ | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G87523 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 907349 | 05 | |
| AZ | TAX ID | 651170616 | 01 |
| Street Address |
1896 E BABBITT LANE |
| City | SAN LUIS |
| State | AZ |
| Zip Code | 85349-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598391351 | Bryson Lee Wandling | Physician Assistant | 815 E. Cesar Chavez Blvd., San Luis, AZ 85349 | 2020-03-12 |
| 1306482377 | Cecilia Denise Zepeda | Registered Nurse | 1250 N. 8th Avenue, San Luis, AZ 85349 | 2019-11-25 |
| 1184142317 | Rosenda Uribe | Specialist/Technologist | 337 Adobe St, San Luis, AZ 85349 | 2017-09-08 |
| 1033644372 | Lourens Rasmus Botha | Pharmacist | 1613 N Main Street, San Luis, AZ 85349 | 2017-04-24 |
| 1205389988 | Miriam Gonzalez | Dentist | 801 North 2nd Ave, San Luis, AZ 85349 | 2016-07-28 |
| 1386016269 | Isabel M Arias | Dental Hygienist | 1896 E. Babbitt Ln., San Luis, AZ 85349 | 2015-10-30 |
| 1801262308 | Rosario Alejandra Morales Villegas | Specialist/Technologist | 1657 E. B Street, San Luis, AZ 85349 | 2015-08-19 |
| 1598142291 | Manuel Angel Salcido | Specialist/Technologist, Other | 1959 E Georgina St, San Luis, AZ 85349 | 2015-05-01 |
| 1508269465 | Christina Mclean | Registered Nurse | 1250 N. 8 Ave., San Luis, AZ 85349 | 2014-10-06 |
| 1134542921 | Gerardo Garcia | Pharmacist | 1613 N Main St, San Luis, AZ 85349 | 2014-01-29 |
| Find all providers in zip 85349 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548693286 | Sunset Community Health Center | Pediatrics | 1245 N Main Street, San Luis, AZ 85349-2017 | 2013-08-16 |
| 1689658163 | Jean M. Amon | Pediatrics | 1896 E. Babbit Ln, Suite D, San Luis, AZ 85349 | 2005-11-30 |
| 1528500576 | Victoria Lasala | Pediatrics | 1896 E Babbitt Ln, San Luis, AZ 85349 | 2016-11-08 |
| 1003211095 | Fnu Pardeep | Pediatrics | 815 E Juan Sanchez Blvd, San Luis, AZ 85349 | 2014-11-03 |
| 1306046677 | Sucharitha Gunasekera | Pediatrics | 815 E Juan Sanchez Blvd, San Luis, AZ 85349 | 2007-07-24 |
| 1801007000 | Leonardo Rodriguez | Pediatrics | 1896 E Babbitt Ln, San Luis, AZ 85349 | 2007-05-27 |
| 1508072430 | Rakesh Kumar Arora | Pediatrics | 815 E Juan Sanchez Blvd, San Luis, AZ 85349-2017 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272700 | Pediatric Multicare West, LLC | Pediatrics | 316 W. White Mountain Blvd., Suite A, Lakeside, AZ 85929 | 2020-10-12 |
| 1629614466 | Kayla Leanne Cantu | Pediatrics | 15264 W Brookside Ln Ste 155, Surprise, AZ 85374-3997 | 2019-11-26 |
| 1306487350 | Roots Pediatric Therapy, LLC | Pediatrics | 7340 E Legacy Blvd Unit C2006, Scottsdale, AZ 85255-6388 | 2019-10-01 |
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1952965212 | Jeremey William Gneck | Pediatrics | 1625 N Campbell Ave Tucson Az 85719, Tucson, AZ 85724-0001 | 2019-04-23 |
| 1164985305 | Desert Sky Pediatrics | Pediatrics | 3301 N Miller Rd Ste 170, Scottsdale, AZ 85251-6421 | 2019-04-12 |
| 1780146829 | Jb Healthcare LLC | Pediatrics | 10575 W Indian School Rd Ste 103, Avondale, AZ 85392-5651 | 2019-04-05 |
| 1902370349 | Dwayne St. Jacques Md Pllc | Pediatrics | 15215 South 48th Street, Suite 110, Phoenix, AZ 85044-9375 | 2019-01-18 |
| 1245703966 | Pleasant Pediatrics Plc | Pediatrics | 15715 S 46th St Ste 102, Phoenix, AZ 85048-0439 | 2019-01-04 |
| 1992295158 | Melanie Anne Kaplanek | Pediatrics | 1501 N Campbell Ave Rm 3301, Tucson, AZ 85724-0001 | 2018-05-14 |
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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.