Rosemary H Roderick Roseberry, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J0228 Issued in TX

Practice address

Brooke Army Medical Center
3551 Roger Brooke Dr.
Jbsa Fort Sam Houston, TX 78234-4504

Phone

(214) 395-7573

NPI assigned

Aug 4, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1942218862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DR.",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DR.",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "214-395-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK ROSEBERRY",
        "first_name": "ROSEMARY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-07-19",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116436002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370007273",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Prichard, DO, RDCS
• Emily Raetz
• Bryan Christopher Ramsey, MD
• Evan M. Renz, M.D.
• Aitana Rizzo, MD
• Niels August Ryden, MD
• Danielle Marie Santos, MD
• Katrina Savioli, MD
• Robert A Seegmiller, PH.D., ABPP
• Alex Leor Shapiro, D.O.

• Pediatrics Physician in Jbsa Fort Sam Houston, TX
• Providers in Jbsa Fort Sam Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.