Individual provider Active NPI

Jana L Roddy, N.P.

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1801843636
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
246698 Issued in TX
Practice address
4004 82ND St
Lubbock, TX 79423-1900
Phone
(806) 722-3180
Fax
(806) 722-3185
NPI assigned
May 27, 2006
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 246698 TX Primary

Addresses

Primary practice location

4004 82ND St
Lubbock, TX 79423-1900

Mailing address

5219 City Bank Pkwy Ste 133
Lubbock, TX 79407-3544
Phone (806) 785-2045

Other identifiers 1

IdentifierTypeStateIssuer
94872589MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
246698TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Allergy & Asthma Center of Duncanville PA PastSince Oct 6, 2014 Accepting new patients
Roswell Clinic Corp Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1801843636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY STE 133",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073544",
            "telephone_number": "806-785-2045",
            "fax_number": "806-785-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231900",
            "telephone_number": "806-722-3180",
            "fax_number": "806-722-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "JANA",
        "middle_name": "L",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "246698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94872589",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.