Individual provider Active NPI

Audrey Corrin Rodriquez

  • Speech-Language Pathologist
  • Plainview, TX
National Provider Identifier
1104590454
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
116813 Issued in TX
Practice address
2417 Yonkers St
Plainview, TX 79072-1819
Phone
(806) 293-6090
NPI assigned
Aug 2, 2021
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 116813 TX Primary

Addresses

Primary practice location

2417 Yonkers St
Plainview, TX 79072-1819

Mailing address

1103 Holly St
Levelland, TX 79336-5763
Phone (806) 535-1716

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
116813TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1104590454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 HOLLY ST",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793365763",
            "telephone_number": "806-535-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 YONKERS ST",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790721819",
            "telephone_number": "806-293-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIQUEZ",
        "first_name": "AUDREY",
        "middle_name": "CORRIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "116813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.