Individual provider Active NPI

Christina Joanne O'Hara-Rodriguez, PA-C

  • Physician Assistant
  • Clarksville, TN
National Provider Identifier
1194243709
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3252 Issued in TN
Practice address
803 River Run
Clarksville, TN 37043-6042
Phone
(781) 443-5007
NPI assigned
Sep 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 3252 TN Primary

Addresses

Primary practice location

803 River Run
Clarksville, TN 37043-6042

Mailing address

803 River Run
Clarksville, TN 37043-6042
Phone (781) 443-5007

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christina.o.hara-rodriguez.3@1879.direct.athenahealth.com

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
I20181012001149 TN Practitioner - Physician Assistant 0547512923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Physician Services, LLCGroup PAC ID 0547276917, 27 clinicians

Practice addresses (Care Compare)

647 Dunlop LN
Clarksville, TN 37040-5165

651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-5080

Hospital & facility affiliations

  • Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3252TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Physician Services LLC Physician Assistant CurrentSince Dec 18, 2017 Accepting new patients

Locations

647 Dunlop Ln
Ste 210
Clarksville, TN 37040
Phone (931) 502-3810

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

647 Dunlop Ln
Ste 206
Clarksville, TN 37040
Phone (931) 232-5141

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1504396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194243709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 RIVER RUN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436042",
            "telephone_number": "781-443-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 RIVER RUN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436042",
            "telephone_number": "781-443-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA-RODRIGUEZ",
        "first_name": "CHRISTINA",
        "middle_name": "JOANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-03",
        "last_updated": "2022-07-21",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christina.o.hara-rodriguez.3@1879.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "647 Dunlop Ln Ste 210",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.