Brentin Lee Roller, D.O.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

006943 Issued in AZ

Practice address

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2759

Phone

(602) 789-0344

Fax

(602) 870-7566

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1134483050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212759",
            "telephone_number": "602-789-0344",
            "fax_number": "602-870-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212759",
            "telephone_number": "602-789-0344",
            "fax_number": "602-870-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "BRENTIN",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "006943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lia Clemente Roley, PSY.D.
• Nancy Ellyn Rolfe, M.D.
• Joshua Russell Rolin, PHARM.D.
• Eric William Rollender, PHAM.D
• Paula S Roller Bachmann, P.T.
• Sarah Camille Rollinger, MED
• Caitlin Lilah Rollins Burt
• Kassaundra Rollins, CCC-SLP
• Katherine Chen Rollins, DO
• Kulinda Rollins

• Infectious Disease Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Infectious Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.

Verify at the official NPI Registry.