Individual provider Active NPI

Rodney Dy Wolpert, FPMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1356534473
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP8220 Issued in AZ
Practice address
530E McDowell Rd 10-479
Phoenix, AZ 85004-1549
Phone
(602) 300-8135
Fax
(602) 926-2746
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 2770 CA
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 2770 CA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 2770 CA
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X 2770 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP8220 AZ Primary

Addresses

Primary practice location

530E McDowell Rd 10-479
Phoenix, AZ 85004-1549

Mailing address

323W Roosevelt St 100
Phoenix, AZ 85003-1360
Phone (602) 300-8135

Other names 1

  • Rodney Dy Wolpert Other name

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17585CAMDDentist
AP8220AZMDPsychiatric/Mental Health Nurse Practitioner
2770CAMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1356534473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323W ROOSEVELT ST 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031360",
            "telephone_number": "602-300-8135",
            "fax_number": "602-926-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530E MCDOWELL RD 10-479",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041549",
            "telephone_number": "602-300-8135",
            "fax_number": "602-926-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPERT",
        "first_name": "RODNEY",
        "middle_name": "DY",
        "credential": "FPMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "2770",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2770",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "2770",
            "primary": false
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "CA",
            "license": "2770",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODNEY",
            "last_name": "WOLPERT",
            "middle_name": "DY",
            "credential": "FPMHNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.