Individual provider Active NPI

Edgar Omar Rodriguez, RDH

  • Military Health Care Provider
  • Norfolk, VA
National Provider Identifier
1093913402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
7920 Issued in NC
Practice address
Uss Bataan LHD-5
Fpo Ae
Norfolk, VA 09554-1657
Phone
(757) 445-6344
NPI assigned
Jul 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 7920 NC Primary

Addresses

Primary practice location

Uss Bataan LHD-5
Fpo Ae
Norfolk, VA 09554-1657

Mailing address

20290 Apricot LN
Caldwell, ID 83607-9480
Phone (208) 602-7014

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

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093913402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20290 APRICOT LN",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836079480",
            "telephone_number": "208-602-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USS BATAAN LHD-5",
            "address_2": "FPO AE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "095541657",
            "telephone_number": "757-445-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EDGAR",
        "middle_name": "OMAR",
        "name_prefix": "Mr.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NC",
            "license": "7920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.