Individual provider Active NPI

Alfredo Rodriguez, M.D.

  • Psychiatry Physician
  • Starkville, MS
National Provider Identifier
1164434882
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16293 Issued in MS
Practice address
302 N Jackson St
Starkville, MS 39759-2504
Phone
(662) 323-9318
Fax
(662) 323-5553
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16293 MS Primary

Addresses

Primary practice location

302 N Jackson St
Starkville, MS 39759-2504

Mailing address

1032 State Hwy 50 W
West Point, MS 39773
Phone (662) 524-4347

Other identifiers 1

IdentifierTypeStateIssuer
0125446MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000336 MS Practitioner - Psychiatry 4284733916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Region Seven Mental Health Intellectual Disabilities CommGroup PAC ID 3072531953, 12 clinicians

Practice addresses (Care Compare)

302 N Jackson St
Starkville, MS 39759-2504
Phone (601) 323-9261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16293MSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Region Seven Mental Health Intellectual Disabilities Comm CurrentSince Apr 3, 2017 Accepting new patients
Region IV Mental Health Services CurrentSince Jun 1, 2015 Accepting new patients
Region IV Desoto County Pharmacy CurrentSince Jun 1, 2015 Accepting new patients
Region IV Mental Health Services Current Accepting new patients

Locations

601 Foote St
Corinth, MS 38834
Phone (662) 287-4424

302 N Jackson St
Starkville, MS 39759
Phone (662) 323-9261

Organizations & group practices 4

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1164434882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 STATE HWY 50 W",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "39773",
            "telephone_number": "662-524-4347",
            "fax_number": "662-524-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N JACKSON ST",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592504",
            "telephone_number": "662-323-9318",
            "fax_number": "662-323-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALFREDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "16293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125446",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

Verify at the official NPI Registry.