Active NPI
Ida Marie Ibarra Rodriguez, RD
- Registered Dietitian
- Lexington, KY
National Provider Identifier
1225694789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 240942
- Practice address
- 2692 Braden Way
Lexington, KY 40509-8571 - Phone
- (787) 922-2177
- NPI assigned
- May 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 240942 | KY | Primary |
Addresses
Primary practice location
2692 Braden Way
Lexington, KY 40509-8571
Mailing address
2692 Braden Way
Lexington, KY 40509-8571
Phone (787) 922-2177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240942 | KY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1225694789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2692 BRADEN WAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405098571",
"telephone_number": "787-922-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2692 BRADEN WAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405098571",
"telephone_number": "787-922-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA RODRIGUEZ",
"first_name": "IDA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-10",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "240942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.