Active NPI
Renata Roddy, FNP-BC
- Family Nurse Practitioner
- North Andover, MA
National Provider Identifier
1093264343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2270636
- Practice address
- 555 Turnpike St Ste 31
North Andover, MA 01845-5935 - Phone
- (978) 683-4299
- NPI assigned
- Sep 28, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2270636 | MA | Primary |
Addresses
Primary practice location
555 Turnpike St Ste 31
North Andover, MA 01845-5935
Mailing address
100 Heard St Unit 521
Chelsea, MA 02150-1973
Phone (781) 588-3176
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 |
|---|---|---|---|
| 2270636 | MA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482192000000",
"number": "1093264343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HEARD ST UNIT 521",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021501973",
"telephone_number": "781-588-3176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 TURNPIKE ST STE 31",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018455935",
"telephone_number": "978-683-4299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODDY",
"first_name": "RENATA",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2016-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "2270636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.