Active NPI
Heather Lee Rodriguez, LPN
- Licensed Practical Nurse
- Watertown, NY
National Provider Identifier
1245095678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 345318
- Practice address
- 595 W Main St
Watertown, NY 13601-1335 - Phone
- (888) 585-2228
- NPI assigned
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 345318 | NY | Primary |
| Licensed Vocational Nurse | 164X00000X | 244973 | CA |
Addresses
Primary practice location
595 W Main St
Watertown, NY 13601-1335
Mailing address
8207A S Lewis Ave
Fort Drum, NY 13603-2014
Phone (760) 684-2727
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 |
|---|---|---|---|
| 345318 | NY | MD | Licensed Practical Nurse |
| 244973 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1245095678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8207A S LEWIS AVE",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136032014",
"telephone_number": "760-684-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 W MAIN ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011335",
"telephone_number": "888-585-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "HEATHER",
"middle_name": "LEE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-15",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "345318",
"primary": true
},
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "244973",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.