Michael M. Rodriguez, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

000353 Issued in CT

Practice address

2 Pomperaug Office Park
Suite 303
Southbury, CT 06488-2288

Phone

(203) 264-1735

Fax

(203) 264-9251

NPI assigned

Feb 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003942988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 SHELTER ROCK RD UNIT 8",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107067",
            "telephone_number": "203-797-0073",
            "fax_number": "203-264-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 303",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-1735",
            "fax_number": "203-264-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Repecki, PT
• Edwin Rexach
• Lindsay Ann Richard, DPT
• Victor A Richardson, OD
• Maysoun Richi, M.D.
• Megan Rom, OTR/L
• Evelyn Karen Roman
• Michele Romaniello
• Elise M Romanik, M.D.
• Mariah Root

• Athletic Trainer in Southbury, CT
• Providers in Southbury, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.