Active NPI
Mario Rodriguez Jr.
- Registered Nurse
- Madera, CA
National Provider Identifier
1053594689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- PENDING
- Practice address
- 14215 Road 28
Madera, CA 93638-5715 - Phone
- (559) 675-7893
- Fax
- (559) 674-7262
- NPI assigned
- Dec 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | PENDING | CA | Primary |
Addresses
Primary practice location
14215 Road 28
Madera, CA 93638-5715
Mailing address
14215 Road 28
Madera, CA 93638-5715
Phone (559) 675-7893
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1053594689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14215 ROAD 28",
"city": "MADERA",
"state": "CA",
"postal_code": "936385715",
"telephone_number": "559-675-7893",
"fax_number": "559-674-7262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14215 ROAD 28",
"city": "MADERA",
"state": "CA",
"postal_code": "936385715",
"telephone_number": "559-675-7893",
"fax_number": "559-674-7262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "MARIO",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-05",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.