Marilyn Anne Roderick, M,D,

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

200401311 Issued in NC

Practice address

15 Hill PLZ
Suite a
Whiteville, NC 28472-4950

Phone

(910) 207-6440

Fax

(910) 207-6444

NPI assigned

May 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Locations

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.

• The Azzato Clinic, PLLC

  • Orthopaedic Surgery Physician
  • Southport, NC
  • NPI 1639990260

  General Practice

  NPD

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1932334166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COMMERCE PLAZA CIR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727386",
            "telephone_number": "910-521-2900",
            "fax_number": "910-775-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HILL PLZ",
            "address_2": "SUITE A",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724950",
            "telephone_number": "910-207-6440",
            "fax_number": "910-207-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "MARILYN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M,D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G-53149",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "200401311",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "MD-11467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Right Foundaton Inc
• Robin'S Nest Family Care Home LLC
• Amber Marie Wallace Robinson, COTA/L
• Loretta Robinson
• Rocky Mountain Holdings, LLC
• Meagan Elizabeth Rooks
• Maleah Rachelle Roth, PA
• Rouse Counseling & Consulting Services
• Ebone' Jane'T Rouse, LCAS
• Anthony Ruan, PHARMD

• All providers in Whiteville, NC
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.