Active NPI
Robert Paul Roddenberry, M.D.
- Obstetrics & Gynecology Physician
- Macon, GA
National Provider Identifier
1295754828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 043756
- Practice address
- 380 Hospital Drive
Suite 100
Macon, GA 31217 - Phone
- (478) 743-4646
- Fax
- (478) 742-5549
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 043756 | GA | Primary |
Addresses
Primary practice location
380 Hospital Drive
Suite 100
Macon, GA 31217
Mailing address
380 Hospital Drive
Suite 100
Macon, GA 31217
Phone (478) 743-4646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00759217A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Medical College of Georgia School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
380 Hospital Dr
Suite 100
Macon, GA 31217-8005
Phone (478) 743-4646
Hospital & facility affiliations
- Coliseum Medical Centers, LLC, Dba
- Atrium Health Navicent the Medical Center
- Emory Houston Hospital Warner Robins
- Fairview Park Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043756 | GA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OBGYN Specialists | Current | Accepting new patients |
Locations
380 Hospital Dr
Ste 100
Macon, GA 31217
Phone (478) 743-4646
Interoperability endpoints
- https://api.platform.athenahealth.com/22824/brand/1/csg/1/fhir/r4
- robert.roddenberry@obgspec.eclinicaldirectplus.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Obstetrics Physician
- Macon, GA
- NPI 1952406761
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Piedmont Macon Medical Center
- General Acute Care Hospital
- Macon, GA
- NPI 1598719643
-
dba Fairview Park Hospital
- General Acute Care Hospital
- Dublin, GA
- NPI 1285688234
-
dba Emory Hospital Warner Robins
- General Acute Care Hospital
- Warner Robins, GA
- NPI 1962435792
-
dba Atrium Health Navicent The Medical Center
- General Acute Care Hospital
- Macon, GA
- NPI 1043270564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295754828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 HOSPITAL DRIVE",
"address_2": "SUITE 100",
"city": "MACON",
"state": "GA",
"postal_code": "31217",
"telephone_number": "478-743-4646",
"fax_number": "478-742-5549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 HOSPITAL DRIVE",
"address_2": "SUITE 100",
"city": "MACON",
"state": "GA",
"postal_code": "31217",
"telephone_number": "478-743-4646",
"fax_number": "478-742-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODDENBERRY",
"first_name": "ROBERT",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "GA",
"license": "043756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00759217A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.