John Ryan Rodenbough, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2257 Issued in NC

Practice address

1126 N Church St Ste 103
Greensboro, NC 27401-1035

Phone

(336) 663-4900

Fax

(336) 663-4920

NPI assigned

Jun 10, 2006

Last updated

Aug 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, shared by 11 NPIs, 724 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrodenbough18317@direct.conehealth.com

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.

• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  Psychologist

  Medicare reassignment NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Center for Maternal Fetal Care

  • Maternal & Fetal Medicine Physician
  • Greensboro, NC
  • NPI 1891351847
  Medicare reassignment NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  dba Cone Health Community Pharmacy at Eden

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1932140779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 103",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011035",
            "telephone_number": "336-663-4900",
            "fax_number": "336-663-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENBOUGH",
        "first_name": "JOHN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2257",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0405V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5857267",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B5701",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrodenbough18317@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1126 N Church St Ste 103",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Toni Johnette Rockholt-Smith, DO
• Regina Jo Roczniak, PA-C
• Janet Lynn Rodden, M.ED.
• Myron Roddenberry, PA
• Ashley Roden
• Frances Rodgers
• Thomas Rodgers Jr., MS, RDN, LDN
• Ana Rodriguez de Blas
• Carlos Rodriguez
• Crystal Rodriguez

• Psychologist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.