Active NPI
Jose Rodriguez
- Foster Care Agency
- Tolleson, AZ
National Provider Identifier
1073888178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- License
- 2000704
- Practice address
- 10348 W Raymond St
Tolleson, AZ 85353-7639 - Phone
- (602) 348-8857
- NPI assigned
- Mar 21, 2012
- Last updated
- Sep 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | NU | ||
| Child Mental Illness Respite Care | 385HR2055X | 2000704 | AZ | |
| Foster Care Agency | 253J00000X | 2000704 | AZ | Primary |
Addresses
Primary practice location
10348 W Raymond St
Tolleson, AZ 85353-7639
Mailing address
10348 W Raymond St
Tolleson, AZ 85353-7639
Phone (602) 348-8857
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 |
|---|---|---|---|
| 2000704 | AZ | MD | Foster Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways of Arizona, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Clarvida
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tucson, AZ
- NPI 1275845646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1073888178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10348 W RAYMOND ST",
"city": "TOLLESON",
"state": "AZ",
"postal_code": "853537639",
"telephone_number": "602-348-8857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10348 W RAYMOND ST",
"city": "TOLLESON",
"state": "AZ",
"postal_code": "853537639",
"telephone_number": "602-348-8857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JOSE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-21",
"last_updated": "2022-09-26",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "2000704",
"primary": false
},
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": "AZ",
"license": "2000704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolleson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.