Active NPI
Pam Derolf, R.T.
- Mammography Radiologic Technologist
- Kill Devil Hills, NC
National Provider Identifier
1891144093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mammography Radiologic Technologist
- License
- 16286
- Practice address
- 152 Swan View Dr
Kill Devil Hills, NC 27948-8048 - Phone
- (401) 862-1688
- NPI assigned
- Jun 8, 2016
- Last updated
- Jun 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mammography Radiologic Technologist | 2471M2300X | 16286 | MA | Primary |
Addresses
Primary practice location
152 Swan View Dr
Kill Devil Hills, NC 27948-8048
Mailing address
152 Swan View Dr
Kill Devil Hills, NC 27948-8048
Phone (401) 862-1688
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16286 | MA | MD | Mammography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1891144093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 SWAN VIEW DR",
"city": "KILL DEVIL HILLS",
"state": "NC",
"postal_code": "279488048",
"telephone_number": "401-862-1688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 SWAN VIEW DR",
"city": "KILL DEVIL HILLS",
"state": "NC",
"postal_code": "279488048",
"telephone_number": "401-862-1688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROLF",
"first_name": "PAM",
"credential": "R.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-08",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2471M2300X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Mammography",
"state": "MA",
"license": "16286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kill Devil Hills, NC
- Christine Damrose-Mahlmann, NCLCMHC, VALPC, NCC
- Kaitlyn Daniels, MA
- Dare County Administrative Offices (County of Dare EMS)
- Dare Vision Center O.D. P.a.
- Shelley Ann Davis, NC LMBT
- Amanda Destefano, BT
- Carol A. Dodson, N.P.
- Steven M Doering, D.M.D.
- Eckerd Corporation (Rite Aid Pharmacy 11428)
- Clyde Gordon Eure, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.