Individual provider Active NPI

Miguel H Rodriguez, MD

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1467492769
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21005 Issued in TN
Practice address
6019 Walnut Grove Rd
Baptist Memphis Memorial Hospital
Memphis, TN 38120-2113
Phone
(901) 226-3020
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21005 TN Primary
Emergency Medicine Physician 207P00000X 13982 MS

Addresses

Primary practice location

6019 Walnut Grove Rd
Baptist Memphis Memorial Hospital
Memphis, TN 38120-2113

Mailing address

6019 Walnut Grove Rd
Baptist Memphis Memorial Hospital
Memphis, TN 38120-2113
Phone (901) 226-3020

Other identifiers 2

IdentifierTypeStateIssuer
3070602MedicaidTN
00116126MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050405001332 TN Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3476500034 Reassigns benefits to 1 organization
I20120327000139 MS Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3476500034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Creek Emergency Physicians PLLC Emergency Medicine CurrentSince Dec 30, 2022 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2005 Accepting new patients
Baptist Memorial Hospital Past Accepting new patients
Parkridge Medical Center, Inc. Past Accepting new patients

Locations

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

7402 Lee Hwy
Chattanooga, TN 37421
Phone (423) 242-9750

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1467492769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "address_2": "BAPTIST MEMPHIS MEMORIAL HOSPITAL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202113",
            "telephone_number": "901-226-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "address_2": "BAPTIST MEMPHIS MEMORIAL HOSPITAL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202113",
            "telephone_number": "901-226-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MIGUEL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "21005",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3070602",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116126",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.