Individual provider Active NPI

Christanie Rodriguez, M.S, ATC, LAT

  • Athletic Trainer
  • Wichita Falls, TX
National Provider Identifier
1023488988
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT4493 Issued in TX
Practice address
3410 Taft Blvd
D.L Ligon Coliseum 158
Wichita Falls, TX 76308-2036
Phone
(940) 397-4815
Fax
(940) 397-4901
NPI assigned
Oct 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT4493 TX Primary

Addresses

Primary practice location

3410 Taft Blvd
D.L Ligon Coliseum 158
Wichita Falls, TX 76308-2036

Mailing address

3410 Taft Blvd
D.L Ligon Coliseum 158
Wichita Falls, TX 76308-2036
Phone (940) 397-4815

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AT4493TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1443830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1023488988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 TAFT BLVD",
            "address_2": "D.L LIGON COLISEUM 158",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082036",
            "telephone_number": "940-397-4815",
            "fax_number": "940-397-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 TAFT BLVD",
            "address_2": "D.L LIGON COLISEUM 158",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082036",
            "telephone_number": "940-397-4815",
            "fax_number": "940-397-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHRISTANIE",
        "credential": "M.S, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-03",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT4493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.