Roderic Rettig, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9270207 Issued in FL

Practice address

2500 N Federal Hwy
Ste 301
Ft Lauderdale, FL 33305-1618

Phone

(954) 533-1520

Fax

(954) 368-5195

NPI assigned

Jan 15, 2015

Last updated

Jun 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1609265578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N FEDERAL HWY, #301",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333054824",
            "telephone_number": "954-533-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N FEDERAL HWY",
            "address_2": "STE 301",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051618",
            "telephone_number": "954-533-1520",
            "fax_number": "954-368-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "RODERIC",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9270207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015607300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.