Individual provider Active NPI

Mario Ronaire Yuzon Rodriguez, RN

  • Registered Nurse
  • League City, TX
National Provider Identifier
1558838458
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
749269 Issued in TX
Practice address
6116 Castle Peak LN
League City, TX 77573-5820
Phone
(607) 341-0881
NPI assigned
Oct 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 749269 TX Primary

Addresses

Primary practice location

6116 Castle Peak LN
League City, TX 77573-5820

Mailing address

6116 Castle Peak LN
League City, TX 77573-5820
Phone (607) 341-0881

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
749269TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1558838458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 CASTLE PEAK LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735820",
            "telephone_number": "607-341-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 CASTLE PEAK LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735820",
            "telephone_number": "607-341-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIO RONAIRE",
        "middle_name": "YUZON",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "749269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.