{"npi":"1124120290","type":"NPI-1","status":"active","name":{"display":"David Rodeberg MD","other":[],"first":"DAVID","last":"RODEBERG","middle":"ANTHONY","credential":"MD"},"specialty":{"primary_taxonomy":"2086S0120X","primary_taxonomy_description":"Pediatric Surgery Physician","slug":"pediatric-surgery-physician","schema_org_specialty":null,"all":[{"code":"2086S0120X","description":"Pediatric Surgery Physician","primary":false,"state":"PA","license":"MD429509"},{"code":"2086S0120X","description":"Pediatric Surgery Physician","primary":false,"state":"KY","license":"TP683"},{"code":"2086S0120X","description":"Pediatric Surgery Physician","primary":true,"state":"NC","license":"2010-00640"}]},"addresses":[{"purpose":"LOCATION","street_1":"517 MOYE BLVD","city":"GREENVILLE","state":"NC","postal_code":"278342849","country_code":"US","phone":"2527442832","fax":"2527443457"},{"purpose":"MAILING","street_1":"PO BOX 751069","city":"CHARLOTTE","state":"NC","postal_code":"282751069","country_code":"US"}],"license":{"state":"NC","number":"2010-00640"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"5914874","state":"NC","issuer":null},{"type_code":"01","label":"Other","value":"158YP","state":"NC","issuer":"BCBSNC"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20200310002338","type_code":"14-37","type_desc":"PRACTITIONER - PEDIATRIC MEDICINE","state":"MO","pac_id":"9537168653"},{"enrlmt_id":"I20220512002805","type_code":"14-02","type_desc":"PRACTITIONER - GENERAL SURGERY","state":"KY","pac_id":"9537168653"}]},"enumeration_date":"2006-09-01","last_updated":"2022-04-05","_meta":{"source":"NPPES","snapshot_date":"2022-04-05","doc_url":"https://findmynpi.com/api"}}