Individual provider Active NPI

Jose A Rodriguez, DNP

  • Acute Care Clinical Nurse Specialist
  • Columbia, SC
National Provider Identifier
1093390775
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
27906 Issued in SC
Practice address
1920 Pickens St
Columbia, SC 29201-2632
Phone
(301) 820-0301
NPI assigned
Mar 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 27906 SC Primary

Addresses

Primary practice location

1920 Pickens St
Columbia, SC 29201-2632

Mailing address

1920 Pickens St
Columbia, SC 29201-2632
Phone (803) 254-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251121000930 SC Practitioner - Certified Clinical Nurse Specialist (CNS) 5496247090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Uniformed Services Uhs Fe Hebert School of Med, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1920 Pickens St
Columbia, SC 29201-2632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27906SCMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Surg Center Inc CurrentSince Oct 16, 2025 Accepting new patients
Columbia Eye Surgery Center Inc CurrentSince Oct 16, 2025 Accepting new patients

Locations

1920 Pickens St
Columbia, SC 29201
Phone (803) 254-7732

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1093390775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012632",
            "telephone_number": "803-254-7732",
            "fax_number": "803-748-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012632",
            "telephone_number": "301-820-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "SC",
            "license": "27906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.