Charito Rodriguez, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT006289 Issued in GA

Practice address

1110 S Pierce St Ste a
Alma, GA 31510-3718

Phone

(912) 342-8875

Fax

(912) 342-8016

NPI assigned

Sep 28, 2022

Last updated

Sep 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Therapies of SE Ga, LLC

  • Pediatric Occupational Therapist
  • Brunswick, GA
  • NPI 1841577111

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1346964913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203016",
            "telephone_number": "912-342-8016",
            "fax_number": "912-342-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S PIERCE ST STE A",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315103718",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Boulevard Sq Ste F",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315018022",
            "country_code": "US",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHARITO",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT006289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klay Mullis, PTA
• Optim Orthopedics, LLC (Optim Orthopedics)
• Arianne Pilpil, PT
• Ralph H Proenza, DDS
• Jenna Miles Reeves, PHARMD
• Roots Chiropractic and Wellness
• Shepard Therapy Center
• Deborah Shepard
• Sean Shepard
• Joshua Levi Shook, PTA

• Pediatric Occupational Therapist in Alma, GA
• Providers in Alma, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.