Individual provider Active NPI

Edison D Rodrigues, M.D.

  • Gastroenterology Physician
  • Corpus Christi, TX
National Provider Identifier
1508864489
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
J5672 Issued in TX
Practice address
718 Elizabeth St FL 3
Corpus Christi, TX 78404-2212
Phone
(361) 884-2858
Fax
(361) 879-9015
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TX
Gastroenterology Physician 207RG0100X MD19374 RI
Gastroenterology Physician 207RG0100X J5672 TX Primary
Specialist 174400000X J5672 TX
Internal Medicine Physician 207R00000X J5672 TX

Addresses

Primary practice location

718 Elizabeth St FL 3
Corpus Christi, TX 78404-2212

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

910 E Houston St Ste 550
Tyler, TX 75702-8366
Phone (903) 885-7671

Other practice location 2

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 589-7017

Other practice location 3

950 Warren Ave Ste 301
East Providence, RI 02914-1432
Phone (401) 606-4260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, RI2 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
I20040806000483 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 0749252203 Reassigns benefits to 3 organizations
I20230731001156 RI Practitioner - Gastroenterology 0749252203 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 31, 2022 Accepting new patients
Abdominal Specialists of South Texas CurrentSince Mar 1, 2007 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Dec 5, 2022 Accepting new patients
Shannon Clinic Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Abdominal Specialists of South Texas, LLP Specialist CurrentSince Mar 1, 2007 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Jan 31, 2022 Accepting new patients
Charles N. Thornton, M.D.,P.a. Past Accepting new patients
Collom and Carney Clinic Association Past Accepting new patients

Locations

950 Warren Ave
Ste 301
East Providence, RI 02914
Phone (401) 444-3611

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

718 Elizabeth St
Fl 3
Corpus Christi, TX 78404
Phone (361) 884-2858

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

120 E Harris Ave
San Angelo, TX 76903
Phone (325) 653-6741

5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008

910 E Houston St
Ste 550
Tyler, TX 75702
Phone (903) 510-8718

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Organizations & group practices 10

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1508864489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 ELIZABETH ST FL 3",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042212",
            "telephone_number": "361-884-2858",
            "fax_number": "361-879-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St Ste 550",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028366",
            "country_code": "US",
            "telephone_number": "903-885-7671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757665822",
            "country_code": "US",
            "telephone_number": "903-589-7017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 Warren Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029141432",
            "country_code": "US",
            "telephone_number": "401-606-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "EDISON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "RI",
            "license": "MD19374",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "J5672",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J5672",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J5672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.