Wilson Rodriguez, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

19165 Puritas Ave
Cleveland, OH 44135-1031

Phone

(216) 849-7987

NPI assigned

Jun 5, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1174884340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19165 PURITAS AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441351031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19165 PURITAS AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441351031",
            "telephone_number": "216-849-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "WILSON",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Rodriguez
• Shayra Rodriguez, RBT
• Shelly-Anne Helen Rodriguez, M.D.
• Vanessa Rodriguez
• Wanda Rodriguez, QMHS
• Alyssa Rodriquez
• Marie H. Rodstrom, CRNA
• Sarah Roe
• Jordann Ayanna Roebuck
• Mattew Roehrs, DO

• Independent Duty Corpsman in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Independent Duty Corpsman in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.