Individual provider Active NPI

Ashley Nicole Rodriguez, PT, DPT

  • Geriatric Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1093218810
Registry record updated Mar 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
5501018370 Issued in MI
Practice address
2000 32ND St SE
Grand Rapids, MI 49508-7910
Phone
(616) 452-5900
NPI assigned
Mar 18, 2018
Last updated
Mar 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 5501018370 MI Primary

Addresses

Primary practice location

2000 32ND St SE
Grand Rapids, MI 49508-7910

Mailing address

2871 Englewood Ave SE
Grand Rapids, MI 49508-1533
Phone (616) 401-6948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116001502 MI Practitioner - Physical Therapist in Private Practice 4981039195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1014 E Grand River Ave
Brighton, MI 48116-1804
Phone (810) 273-4170

340 W 40TH St
Holland, MI 49423-4600
Phone (616) 276-4077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018370MIMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Geriatrics CurrentSince Oct 7, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC CurrentSince Oct 7, 2022 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6765

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521331200000",
    "number": "1093218810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 ENGLEWOOD AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495081533",
            "telephone_number": "616-401-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 32ND ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087910",
            "telephone_number": "616-452-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-18",
        "last_updated": "2018-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MI",
            "license": "5501018370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.