John H Roediger, M.D

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD8727 Issued in ME

Practice address

1250 Forest Ave
Portland, ME 04103-1897

Phone

(207) 797-5753

Fax

(207) 797-9571

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1881682789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031897",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDIGER",
        "first_name": "JOHN",
        "middle_name": "H",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "MD8727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "B86271",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302230099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1044199",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "040512",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly J Rodgers, PH.D.
• Katherine Rodney
• Patricia A Rodrigue, CRNA
• Kayla Rodriguez
• Frederick Clapp Roediger, M.D.
• Claire Rogers, RN
• Daniel Joseph Rogers, M.D.
• Diana L Rogers, LMSW-CC
• Jason Rogers, LCSW
• Jennifer A Rogers, NP-C

• Otolaryngology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Otolaryngology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.