Kelcie Ann Rodriguez Peterson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

50082 Issued in KY

Practice address

601 S Floyd St Ste 300
Louisville, KY 40202-1837

Phone

(502) 629-1515

Fax

(502) 629-1545

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Kelcie Ann Rodriguez Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Emergency Medicine Physician
  • Cedar City, UT
  • NPI 1225168610
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1275976243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8406 OXFORD WOODS CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224667",
            "telephone_number": "406-855-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S FLOYD ST STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021837",
            "telephone_number": "502-629-1515",
            "fax_number": "502-629-1545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69 Jesse Hill Jr Dr SE",
            "address_2": "Emory Univ School of Medicine, Glenn Bldng, 412B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033033",
            "country_code": "US",
            "telephone_number": "404-251-8812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ PETERSON",
        "first_name": "KELCIE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "50082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K247810",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007105",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000351117",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "230370",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "601 S Floyd St Ste 300",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021837",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krodriguezpeterson130027@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "601 S Floyd St Ste 300",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELCIE",
            "last_name": "RODRIGUEZ",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roysten Rodrigues
• Danella Mia Rodriguez Adorno, MD
• Dany Rodriguez Gonzalez, APRN
• Alberto I Rodriguez Hernandez
• Manuel Rodriguez Luna
• Luis Rodriguez-Donaire
• April Denise Rodriguez, LCSW
• Desarae Rodriguez, APRN
• Elizabeth Rodriguez
• Gabriela De la Caridad Rodriguez

• Obstetrics & Gynecology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Obstetrics & Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.