NPIMap

Individual provider Active NPI

Jose O Rodriguez-Torres, MD

  • Pediatrics Physician
  • Marietta, GA
National Provider Identifier
1477544591
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
024622 Issued in GA
Practice address
121 Marble Mill Rd NW
Ste 101
Marietta, GA 30060-7959
Phone
(770) 422-8315
Fax
(770) 590-9170
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 024622 GA Primary

Addresses

Primary practice location

121 Marble Mill Rd NW
Ste 101
Marietta, GA 30060-7959

Mailing address

121 Marble Mill Rd
Ste 101
Marietta, GA 30060-7913
Phone (770) 422-8315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrodriguez7471@directwellstar.org

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024622GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Kennestone Pediatric Associates, LLC Pediatrics Past Accepting new patients
Wellstar Health System, Inc. Pediatrics Past Accepting new patients

Locations

121 Marble Mill Rd NW
Ste 101
Marietta, GA 30060
Phone (770) 422-8315

Interoperability endpoints

  • Direct secure messaging: jrodriguez7471@directwellstar.org

Organizations & group practices 3

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1477544591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MARBLE MILL RD",
            "address_2": "STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607913",
            "telephone_number": "770-422-8315",
            "fax_number": "770-590-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MARBLE MILL RD NW",
            "address_2": "STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607959",
            "telephone_number": "770-422-8315",
            "fax_number": "770-590-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-TORRES",
        "first_name": "JOSE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "024622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrodriguez7471@directwellstar.org",
            "affiliation": "N",
            "address_1": "121 Marble Mill Rd NW",
            "address_2": "ste 101",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300607959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.