Rod Evan Pellenberg, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

2017013705 Issued in MO

Practice address

11365 Dorsett Rd.
Maryland Heights, MO 63043

Phone

(314) 872-6400

NPI assigned

Jun 11, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ranken-Jordan Home for Convalescent Crippled Children

  dba Ranken Jordan Pediatric Bridge Hospital

  • General Acute Care Hospital
  • Maryland Heights, MO
  • NPI 1235117532
  NPD (past)

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1902126097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11365 DORSETT ROAD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "63043",
            "telephone_number": "314-872-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11365 DORSETT RD.",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "63043",
            "telephone_number": "314-872-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLENBERG",
        "first_name": "ROD",
        "middle_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2017013705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret J Oney, PNP
• Optum Behavioral Care of Ohio, Inc.
• Optum Palliative and Hospice Care, Inc.
• Our Urgent Care, LLC
• Caleb Owsley, MD
• Hal I Pendergrass, MA
• Kenyon Perkins
• Jasmine L Peterson, MA, PLPC
• Pharmacy Services Inc
• Michelle L Piole, CPNP

• Pediatric Cardiology Physician in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Pediatric Cardiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.