Individual provider Active NPI

Javier Francisco Rodriguez, PA

  • Physician Assistant
  • Murfreesboro, TN
National Provider Identifier
1174555072
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1007 Issued in TN
Practice address
400 N. Highland Ave.
Middle Tennessee Medical Center
Murfreesboro, TN 37130
Phone
(800) 251-2014
Fax
(615) 284-3854
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1007 TN Primary

Addresses

Primary practice location

400 N. Highland Ave.
Middle Tennessee Medical Center
Murfreesboro, TN 37130

Mailing address

One Vantage Way
Suite B240 Middle Tennessee Emergency Physician, PC
Nashville, TN 37228-1562
Phone (615) 329-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040928001035 TN Practitioner - Physician Assistant 7416926266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1007TNMDMarriage & Family Therapist

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1174555072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VANTAGE WAY",
            "address_2": "SUITE B240 MIDDLE TENNESSEE EMERGENCY PHYSICIAN, PC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281562",
            "telephone_number": "615-329-4020",
            "fax_number": "615-329-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N. HIGHLAND AVE.",
            "address_2": "MIDDLE TENNESSEE MEDICAL CENTER",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37130",
            "telephone_number": "800-251-2014",
            "fax_number": "615-284-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAVIER",
        "middle_name": "FRANCISCO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.