Individual provider Active NPI

Anthony Rodriguez, D.C.

  • Chiropractor
  • Tumwater, WA
National Provider Identifier
1124340419
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60136257 Issued in WA
Practice address
1518 Bishop Rd SW # 11
Tumwater, WA 98512-7354
Phone
(360) 923-5588
Fax
(360) 915-9815
NPI assigned
Feb 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60136257 WA Primary

Addresses

Primary practice location

1518 Bishop Rd SW # 11
Tumwater, WA 98512-7354

Mailing address

1060 Hudson St
Longview, WA 98632-3103
Phone (360) 423-2037

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120912000821 WA Practitioner - Chiropractic 3678721859 Practice locations: Longview, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1518 Bishop Rd SW
Tumwater, WA 98512-7354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5547ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Rodriguez DC PLLC Chiropractor CurrentSince Aug 7, 2019 Accepting new patients

Locations

1518 Bishop Rd SW
Bldg 11
Tumwater, WA 98512
Phone (360) 923-5588

1518 Bishop Rd SW
Ste 11
Tumwater, WA 98512

1518 Bishop Rd SW
Tumwater, WA 98512
Phone (360) 823-5588

1518 Bishop Rd SW
#11
Tumwater, WA 98512
Phone (360) 923-5588

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1124340419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 HUDSON ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323103",
            "telephone_number": "360-423-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 BISHOP RD SW # 11",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127354",
            "telephone_number": "360-923-5588",
            "fax_number": "360-915-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANTHONY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-27",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60136257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.