Individual provider Active NPI

Jennifer Garcia Rodriguez

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1184123788
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10914 Issued in AZ
Practice address
15749 W Vernon Ave
Goodyear, AZ 85395-7534
Phone
(602) 810-5178
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP10914 AZ Primary

Addresses

Primary practice location

15749 W Vernon Ave
Goodyear, AZ 85395-7534

Mailing address

15749 W Vernon Ave
Goodyear, AZ 85395-7534
Phone (602) 810-5178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180607002626 AZ Practitioner - Nurse Practitioner 1456616721 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Phoenix, AZ 85050
Phone (480) 320-2725

2836 E Indian School Rd
Suite A8
Phoenix, AZ 85016-6864
Phone (602) 840-0056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Wound Care Az LLC Single Specialty CurrentSince Mar 25, 2025 Accepting new patients
Woundwise LLC Single Specialty CurrentSince Jun 9, 2025 Accepting new patients

Locations

2836 E Indian School Rd
Ste A8
Phoenix, AZ 85016
Phone (602) 840-0056

Organizations & group practices 3

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": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1184123788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15749 W VERNON AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957534",
            "telephone_number": "602-810-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15749 W VERNON AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957534",
            "telephone_number": "602-810-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA RODRIGUEZ",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.