Individual provider Active NPI

Leslie C Rodriguez, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1417384744
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60417675 Issued in WA
Practice address
2807 W Washington Ave Ste 127
Yakima, WA 98903-1367
Phone
(509) 383-4325
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60417675 WA Primary

Addresses

Primary practice location

2807 W Washington Ave Ste 127
Yakima, WA 98903-1367

Mailing address

1417 S 31St Ave
Yakima, WA 98902-5060
Phone (509) 383-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150113001105 WA Practitioner - Nurse Practitioner 5395069710 Practice locations: Yakima, WA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2807 W Washington Ave
Suite 135
Yakima, WA 98903-1367
Phone (509) 383-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1417384744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S 31ST AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025060",
            "telephone_number": "509-383-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 W WASHINGTON AVE STE 127",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989031367",
            "telephone_number": "509-383-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LESLIE",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60417675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.