Individual provider Active NPI

Ricardo Arturo Rodriguez

  • Speech-Language Pathologist
  • Dearborn Heights, MI
National Provider Identifier
1073857843
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101004721 Issued in MI
Practice address
26505 Powers Ave
Dearborn Heights, MI 48125-1327
Phone
(313) 291-6200
NPI assigned
Nov 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Speech-Language Pathologist 235Z00000X 7101004721 MI Primary

Addresses

Primary practice location

26505 Powers Ave
Dearborn Heights, MI 48125-1327

Mailing address

22415 Chestnut Tree
Novi, MI 48375-4307
Phone (810) 210-1688

Other practice location 1

18300 W 12 Mile Rd
Southfield, MI 48076-2670
Phone (248) 559-5820

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

LicenseStateTypeSpecialty
7101004721MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Early Intervention Center Behavior Analyst Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1073857843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22415 CHESTNUT TREE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754307",
            "telephone_number": "810-210-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26505 POWERS AVE",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251327",
            "telephone_number": "313-291-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18300 W 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480762670",
            "country_code": "US",
            "telephone_number": "248-559-5820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RICARDO",
        "middle_name": "ARTURO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.