Individual provider Active NPI

Carmen S Rodriguez, PHD, ARNP

  • Adult Health Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1528043924
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1460152 Issued in FL
Practice address
509 NE 1St St
Gainesville, FL 32601-5308
Phone
(352) 519-5542
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1460152 FL
Oncology Registered Nurse 163WX0200X 1460152 FL
Adult Health Nurse Practitioner 363LA2200X 1460152 FL Primary

Addresses

Primary practice location

509 NE 1St St
Gainesville, FL 32601-5308

Mailing address

3404 NW 34TH St
Gainesville, FL 32605-2140
Phone (352) 256-7171

Other practice location 1

101 S. Newell Drive
Gainesville, FL 32611
Phone (352) 273-6328

Other practice location 2

3404 NW 34th Street
Gainesville, FL 32605
Phone (352) 519-5542

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
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1460152FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1528043924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 NW 34TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326052140",
            "telephone_number": "352-256-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 NE 1ST ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326015308",
            "telephone_number": "352-519-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S. Newell Drive",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "32611",
            "country_code": "US",
            "telephone_number": "352-273-6328",
            "fax_number": "352-273-6536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3404 NW 34th Street",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "32605",
            "country_code": "US",
            "telephone_number": "352-519-5542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARMEN",
        "middle_name": "S",
        "credential": "PHD, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "1460152",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "FL",
            "license": "1460152",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1460152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.