Active NPI
Roger Rholdon Jr.
- Critical Care Pediatric Nurse Practitioner
- Scott, LA
National Provider Identifier
1356757280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- AP07699
- Practice address
- 6100 Cameron St
Scott, LA 70583-5144 - Phone
- (337) 289-6770
- NPI assigned
- Jul 11, 2014
- Last updated
- Jul 11, 2014
- 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 |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | AP07699 | LA | Primary |
Addresses
Primary practice location
6100 Cameron St
Scott, LA 70583-5144
Mailing address
6100 Cameron St
Scott, LA 70583-5144
Phone (337) 289-6770
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 |
|---|---|---|---|
| AP07699 | LA | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405036800000",
"number": "1356757280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 CAMERON ST",
"city": "SCOTT",
"state": "LA",
"postal_code": "705835144",
"telephone_number": "337-289-6770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6100 CAMERON ST",
"city": "SCOTT",
"state": "LA",
"postal_code": "705835144",
"telephone_number": "337-289-6770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHOLDON",
"first_name": "ROGER",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-11",
"last_updated": "2014-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "LA",
"license": "AP07699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scott, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.