Individual provider Active NPI

Maribel Villegas Rodriguez

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1518772979
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86171543 Issued in AZ
Practice address
1625 N 39TH Ave
Phoenix, AZ 85009-2149
Phone
(602) 257-4323
NPI assigned
Feb 11, 2025
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86171543 AZ Primary

Addresses

Primary practice location

1625 N 39TH Ave
Phoenix, AZ 85009-2149

Mailing address

1625 N 39TH Ave
Phoenix, AZ 85009-2149
Phone (602) 257-4323

Other practice location 1

1300 S 10th St
Phoenix, AZ 85034-4516
Phone (602) 257-4323 ext. 2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002367 AZ Practitioner - Registered Dietitian Or Nutrition Professional 6901329572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86171543AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Community Center, Inc CurrentSince Feb 5, 2025 Accepting new patients
Wesley Community Center Inc Current Accepting new patients
Wesley Community Center, Inc CurrentSince Feb 5, 2025 Accepting new patients
Wesley Community Center Inc Past Accepting new patients

Locations

1300 S 10th St
Phoenix, AZ 85034
Phone (602) 257-4323

1625 N 39th Ave
Phoenix, AZ 85009
Phone (602) 233-0017

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1518772979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N 39TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850092149",
            "telephone_number": "602-257-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N 39TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850092149",
            "telephone_number": "602-257-4323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 S 10th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850344516",
            "country_code": "US",
            "telephone_number": "602-257-4323 x2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLEGAS RODRIGUEZ",
        "first_name": "MARIBEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86171543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.