Mary Sun Roh, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M4930 Issued in TX

Practice address

15492 E Prentice Dr
Centennial, CO 80015-4267

Phone

(817) 422-7155

NPI assigned

Aug 30, 2007

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1790979920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15492 E PRENTICE DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154267",
            "telephone_number": "817-422-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15492 E PRENTICE DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154267",
            "telephone_number": "817-422-7155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044909",
            "country_code": "US",
            "telephone_number": "817-702-1307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROH",
        "first_name": "MARY",
        "middle_name": "SUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G58214",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR0052245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Roedel
• Emily Roessel
• Suzanne Lawrence Rogers, D.O.
• Margarethe Emilie Rogg, M.D.
• Daeyoung D Roh, MD
• Marisa Lee Rohlf, C.M.T./H.H.P.
• Brynley Rojas
• Jane Rolland
• Michelle Rollins, M.A., LPC, CACIII
• Oksana Rollins, CNTP

• Pediatrics Physician in Centennial, CO
• Providers in Centennial, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.