Active NPI
Larry Nmi Roediger, PA-C
- Physician Assistant
- Albemarle, NC
National Provider Identifier
1003026550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 101589
- Practice address
- 301 Yadkin St
Albemarle, NC 28001-3441 - Phone
- (704) 984-4382
- Fax
- (704) 984-4631
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 101589 | NC | Primary |
Addresses
Primary practice location
301 Yadkin St
Albemarle, NC 28001-3441
Mailing address
2609 N Duke St
Ste 303B
Durham, NC 27704-3019
Phone (336) 998-3707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101589 | NC | MD | Physician Assistant |
Interoperability endpoints
- lroediger@direct.meditouchehr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500163200000",
"number": "1003026550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2609 N DUKE ST",
"address_2": "STE 303B",
"city": "DURHAM",
"state": "NC",
"postal_code": "277043019",
"telephone_number": "336-998-3707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 YADKIN ST",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280013441",
"telephone_number": "704-984-4382",
"fax_number": "704-984-4631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEDIGER",
"first_name": "LARRY",
"middle_name": "NMI",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2017-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "101589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albemarle, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.