Regina Jo Roczniak, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0010-02313 Issued in NC

Practice address

2704 Henry St
Greensboro, NC 27405-3633

Phone

(336) 621-3777

Fax

(336) 621-8374

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Regina Jo Mancini Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1598812794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 HENRY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053633",
            "telephone_number": "336-621-3777",
            "fax_number": "336-621-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCZNIAK",
        "first_name": "REGINA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02313",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-02313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2762327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINA",
            "last_name": "MANCINI",
            "middle_name": "JO",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberlee R Roche, PA-C
• Michael James Roche, PA-C
• Jennifer Kowalsky Rock, CRNA
• Rockerfeller Crews Educational Foundation
• Toni Johnette Rockholt-Smith, DO
• Janet Lynn Rodden, M.ED.
• Myron Roddenberry, PA
• John Ryan Rodenbough, PSYD
• Frances Rodgers
• Thomas Rodgers Jr., MS, RDN, LDN

• Surgical Physician Assistant in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.

Verify at the official NPI Registry.