Amilcar Ivan Rodriguez, SOIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

1975 Combat Medic Dr
Fort Bragg, NC 28310-0001

Phone

(910) 396-4240

NPI assigned

Oct 9, 2012

Sex

Male

Sole proprietor

No

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": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1194077677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 IVY STONE DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283767381",
            "telephone_number": "910-396-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 COMBAT MEDIC DR",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMILCAR",
        "middle_name": "IVAN",
        "name_prefix": "Mr.",
        "credential": "SOIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lareshia Christine Robinson, MSN-MBA, RN
• Meyassar Robinzine
• Kelsey Lee Rochester, DPT
• Joshua Min Ho Rodin, PA-C
• Daren Scott Rodman
• Ludrena Carmonique Rodriguez, DNP, WHNP-BC, MSCP
• Robert A Rodriguez Jr., PA-C
• Jack E Roets, M.D.
• Robert Joseph Roller Jr., PT, PHD, DPT, ATC
• Betty Roop

• Independent Duty Corpsman in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.