Healthcare Provider Details

I. General information

NPI: 1538077698
Provider Name (Legal Business Name): SADIE RODELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SADIE RUPP

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ERWIN RD
DURHAM NC
27705-4599
US

IV. Provider business mailing address

412 2ND ST
APEX NC
27502-2046
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-6669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberP25217
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: