Individual provider Active NPI

Stephen James Rodney, HIS

  • Specialist
  • Lauderdale Lakes, FL
National Provider Identifier
1336289081
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AS3994 Issued in FL
Practice address
4850 W Oakland Park Blvd
Suite #110
Lauderdale Lakes, FL 33313-7260
Phone
(954) 731-5931
Fax
(954) 731-5931
NPI assigned
Feb 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AS3994 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd
Suite #110
Lauderdale Lakes, FL 33313-7260

Mailing address

533 NW 98TH Ave
Plantation, FL 33324-4954
Phone (954) 560-2994

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AS3994FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336289081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 NW 98TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333244954",
            "telephone_number": "954-560-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "address_2": "SUITE #110",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "954-731-5931",
            "fax_number": "954-731-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODNEY",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "AS3994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.