NPIMap

Individual provider Active NPI

John Gardiner R Roddey Jr., M.D.

  • Gastroenterology Physician
  • Charlotte, NC
National Provider Identifier
1619925419
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
9600706 Issued in NC
Practice address
2015 Randolph Rd
Suite 208
Charlotte, NC 28207-1200
Phone
(704) 377-4009
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 9600706 NC Primary

Addresses

Primary practice location

2015 Randolph Rd
Suite 208
Charlotte, NC 28207-1200

Mailing address

PO Box 497
Huntersville, NC 28070-0497
Phone (704) 377-4009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050502000913 NC Practitioner - Gastroenterology 9830138593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of North Carolina at Chapel Hill School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Gastroenterology and Hepatology PLLCGroup PAC ID 3870489412, shared by 3 NPIs, 76 clinicians

Practice addresses (Care Compare)

11430 Red Rust LN
Charlotte, NC 28277-4948
Phone (704) 377-4009

2015 Randolph Rd
Charlotte, NC 28207-1200
Phone (704) 377-4009

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy203
Upper gastrointestinal (GI) endoscopy for acid reflux129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Apr 1, 2002 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Gastroenterology CurrentSince Apr 1, 2002 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Past Accepting new patients

Locations

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

4425 Randolph Rd
Ste 105
Charlotte, NC 28211

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

16525 Holly Crest Ln
Ste 120
Huntersville, NC 28078
Phone (704) 316-5388

1450 Matthews Township Pkwy
Ste 400
Matthews, NC 28105
Phone (704) 316-5140

115 Commerce Pointe Blvd
Mooresville, NC 28117
Phone (423) 343-7032

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1619925419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280700497",
            "telephone_number": "704-377-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD",
            "address_2": "SUITE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071200",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDEY",
        "first_name": "JOHN",
        "middle_name": "GARDINER R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9600706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.