Active NPI
Kerry Ann Rodocker-Wiarda, D.C.
- Chiropractor
- Pasadena, TX
National Provider Identifier
1972507937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1338
- Practice address
- 5912 Spencer Hwy
Pasadena, TX 77505-1602 - Phone
- (281) 998-6140
- Fax
- (281) 998-0558
- NPI assigned
- Jun 8, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1338 | NE | Primary |
Addresses
Primary practice location
5912 Spencer Hwy
Pasadena, TX 77505-1602
Mailing address
5912 Spencer Hwy
Pasadena, TX 77505-1602
Phone (281) 998-6140
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100251029-00 | Medicaid | NE | |
| 09644 | Other | NE | BC/BS |
| 10025102900 | Medicaid | NE |
Other names 1
- Kerry Ann Rodocker
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13356 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kerry Rodocker | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Grand Island, NE
- NPI 1831303023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1972507937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5912 SPENCER HWY",
"city": "PASADENA",
"state": "TX",
"postal_code": "775051602",
"telephone_number": "281-998-6140",
"fax_number": "281-998-0558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5912 SPENCER HWY",
"city": "PASADENA",
"state": "TX",
"postal_code": "775051602",
"telephone_number": "281-998-6140",
"fax_number": "281-998-0558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODOCKER-WIARDA",
"first_name": "KERRY",
"middle_name": "ANN",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-08",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "1338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100251029-00",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "09644",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025102900",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KERRY",
"last_name": "RODOCKER",
"middle_name": "ANN",
"credential": "D.C.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Pasadena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.