Individual provider Active NPI

Brandi Dawn Rodriguez, NP-BC

  • Family Nurse Practitioner
  • Reynolds, GA
National Provider Identifier
1487472775
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN202299 Issued in GA
Practice address
2319 Roberta Hwy
Reynolds, GA 31076-2047
Phone
(478) 737-4085
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN202299 GA Primary

Addresses

Primary practice location

2319 Roberta Hwy
Reynolds, GA 31076-2047

Mailing address

2319 Roberta Hwy
Reynolds, GA 31076-2047
Phone (478) 737-4085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250130002908 GA Practitioner - Nurse Practitioner 0749719060 Reassigns benefits to 2 organizations
I20260622002307 FL Practitioner - Nurse Practitioner 0749719060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 400
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Pruitthealth Hospice, Inc Current Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Jan 1, 2025 Accepting new patients

Locations

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1487472775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 ROBERTA HWY",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310762047",
            "telephone_number": "478-737-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 ROBERTA HWY",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310762047",
            "telephone_number": "478-737-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "BRANDI",
        "middle_name": "DAWN",
        "credential": "NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN202299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynolds, GA

Sources for this page

Verify at the official NPI Registry.