Stephanie Jennie Roddenberry (NPI# 1649772377, PAC ID# 4789938937) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1649772377 |
| PAC ID by PECOS | 4789938937 |
| Professional Enrollment ID | I20181107001371 |
| Full Name | Stephanie Jennie Roddenberry |
| Organization Legal Name | JOHN W RICHARDSON MD PA |
| Address |
2301 S Fm 51 Suite 500 Decatur TX 76234-3867 |
| Phone Number | 9406270013 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1456312032 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450271 | WISE REGIONAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 2301 S Fm, 51 Suite 500, Decatur, TX 76234-3867 | 9406270013 | JOHN W RICHARDSON MD PA |
| Organization Legal Name | JOHN W RICHARDSON MD PA |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John William Richardson | Family Medicine | John W Richardson Md Pa | 2301 S Fm, 51 Suite 500, Decatur, TX 76234-3867 |
| Street Address |
2301 S FM 51 SUITE 500 |
| City | DECATUR |
| State | TX |
| Zip | 76234-3867 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Henock Zabher | Cardiovascular Disease (cardiology) | Wise Clinical Care Associates | 2301 S Fm, 51 Suite 100, Decatur, TX 76234-3864 |
| Phuong-khanh Jessica Farley | Interventional Cardiology | Wise Clinical Care Associates | 2301 S Fm, 51 Suite 100, Decatur, TX 76234-3864 |
| Steven Young Kim | Pulmonary Disease | Wise Clinical Care Associates | 2301 S Fm, 51 Suite 400, Decatur, TX 76234-3864 |
| John William Richardson | Family Medicine | John W Richardson Md Pa | 2301 S Fm, 51 Suite 500, Decatur, TX 76234-3867 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shirley J Jordan | Clinical Psychologist | 506 N Miller St, Decatur, TX 76234-1114 | |
| Tad Billmire | Optometry | 104 S Washburn St, Decatur, TX 76234-1608 | |
| Edward H Fries | Optometry | 303 S Washburn St, Dba Decatur Eye Center, Decatur, TX 76234-1633 | |
| Ronald W Westbrook | Chiropractic | 1700 W Business, Suite 380, Decatur, TX 76234-3232 | |
| Sanjoy Sundaresan | Pain Management | 1100 W Business, 380 Unit F, Decatur, TX 76234-3268 | |
| Joanne Pham | Otolaryngology | Ent and Allergy Clinic Pa | 1600 W Us Business, 380 Suite A, Decatur, TX 76234-3271 |
| Julie Mistic | Qualified Audiologist | Ent and Allergy Clinic Pa | 1600 W Us Business, 380 Suite A, Decatur, TX 76234-3271 |
| Randall W Mckenna | Orthopedic Surgery | North Central Texas Orthopaedics and Sports Medicine Pa | 1713 S Fm, 51 Suite 103, Decatur, TX 76234-3644 |
| Ricky Lynn Childers | Podiatry | North Central Texas Foot and Ankle, LLC | 1713 S Fm, 51 Suite 103, Decatur, TX 76234-3644 |
| Troy B Chandler | Physician Assistant | North Central Texas Orthopaedics and Sports Medicine Pa | 1713 S Fm, 51 Suite 103, Decatur, TX 76234-3644 |
| Find all physicians in zip 76234 | |||
| City | DECATUR |
| Zip Code | 76234 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DECATUR + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Stephanie Jennie Roddenberry.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.