Active NPI
Susan L Roedder, MD
- Internal Medicine Physician
- Flourtown, PA
National Provider Identifier
1386878718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD021389E
- Practice address
- 6306 Farmar LN
Flourtown, PA 19031-1308 - Phone
- (215) 233-1424
- NPI assigned
- May 13, 2009
- Last updated
- May 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD021389E | PA | Primary |
Addresses
Primary practice location
6306 Farmar LN
Flourtown, PA 19031-1308
Mailing address
6306 Farmar LN
Flourtown, PA 19031-1308
Phone (215) 233-1424
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD021389E | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242172800000",
"number": "1386878718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6306 FARMAR LN",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190311308",
"telephone_number": "215-233-1424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6306 FARMAR LN",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190311308",
"telephone_number": "215-233-1424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEDDER",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-13",
"last_updated": "2009-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD021389E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flourtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.