Perry Clyde Rothrock III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37500 Issued in TN

Practice address

8309 Cordova Rd
Cordova, TN 38016-2046

Phone

(901) 757-9984

Fax

(901) 757-0536

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Perry C. Rothrock III, M.D. PLLC

  • Family Medicine Physician
  • Cordova, TN
  • NPI 1619138377
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1023093655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 CORDOVA RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162046",
            "telephone_number": "901-757-9984",
            "fax_number": "901-757-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8309 CORDOVA RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162046",
            "telephone_number": "901-757-9984",
            "fax_number": "901-757-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHROCK",
        "first_name": "PERRY",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "37500",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C 7965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katarion Rose
• Sara Ross, LCP-MHSP
• Christy A Rosser
• Lolita Rosser
• Anna Rossman
• Rasmoni Roy, M.D.
• Ariella Chana Ruderman, MA, CCC-SLP
• Lamus Rush III
• Lester Leon Russell
• Susan Sheidler Rysedorph, R.D., L.D.N.

• Family Medicine Physician in Cordova, TN
• Providers in Cordova, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.