Active NPI
Rogena D Cordle, MD
- Pediatrics Physician
- Rome, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 043585
- Practice address
- 304 Shorter Ave NW Ste 105
Rome, GA 30165-4256 - Phone
- (706) 291-4880
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 043585 | GA | Primary |
Addresses
Primary practice location
304 Shorter Ave NW Ste 105
Rome, GA 30165-4256
Mailing address
420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000
Other practice location 1
330 Turner McCall Blvd SW
Ste 205
Rome, GA 30165-5630
Phone (706) 234-2324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000757072E | Medicaid | GA |
Other names 1
- Rogena Ann Davis
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rcordle@fmc.gwaydirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070604000118 | GA | Practitioner - Pediatric Medicine | 5799883567 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043585 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd Healthcare Management Inc | Current | Accepting new patients |
Locations
1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212
330 Turner McCall Blvd SW
Ste 107
Rome, GA 30165
Phone (706) 509-6439
304 Shorter Ave NW
Ste 105
Rome, GA 30165
Phone (706) 236-4880
330 Turner McCall Blvd SW
Ste 205
Rome, GA 30165
Phone (706) 234-2324
420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278
500 Riverside Pkwy NE
Rome, GA 30161
Phone (706) 509-3820
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Rome, GA
- NPI 1689610149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1679513360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 E 2ND AVE STE 103",
"city": "ROME",
"state": "GA",
"postal_code": "301613210",
"telephone_number": "706-509-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 SHORTER AVE NW STE 105",
"city": "ROME",
"state": "GA",
"postal_code": "301654256",
"telephone_number": "706-291-4880"
}
],
"practiceLocations": [
{
"address_1": "330 Turner McCall Blvd SW",
"address_2": "Ste 205",
"address_purpose": "LOCATION",
"city": "Rome",
"state": "GA",
"postal_code": "301655630",
"country_code": "US",
"telephone_number": "706-234-2324",
"fax_number": "706-234-1491",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORDLE",
"first_name": "ROGENA",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "043585",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000757072E",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rcordle@fmc.gwaydirect.com",
"affiliation": "N",
"address_1": "330 Turner McCall Blvd SW",
"address_2": "Ste 205",
"city": "Rome",
"state": "GA",
"country_code": "US",
"postal_code": "301655630",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ROGENA",
"last_name": "DAVIS",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.