NPIMap

Organization Active NPI

Rodriguez Clinic and Foundation LLC

  • Psychiatry Physician
  • Metairie, LA
National Provider Identifier
1609001999
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
202660 Issued in LA
Legal business name
RODRIGUEZ CLINIC AND FOUNDATION LLC
Practice address
4421 Conlin St
Suite 101
Metairie, LA 70006-2154
Phone
(504) 455-2002
Fax
(504) 885-4383
NPI assigned
May 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Authorized official

Name
Dr. Jose M. Rodriguez, M.D.NPI 1235399262
Title
Manager
Phone
(504) 455-2002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 202660 LA Primary

Addresses

Primary practice location

4421 Conlin St
Suite 101
Metairie, LA 70006-2154

Mailing address

4421 Conlin St
Suite 101
Metairie, LA 70006-2154
Phone (504) 455-2002

Other identifiers 1

IdentifierTypeStateIssuer
1075353MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150113000688 LA Part B Supplier - Clinic/Group Practice 3476877887 Receives reassigned benefits from 16 practitioners
Practice locations: Covington, LA; Metaire, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1609001999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 CONLIN ST",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062154",
            "telephone_number": "504-455-2002",
            "fax_number": "504-885-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 CONLIN ST",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062154",
            "telephone_number": "504-455-2002",
            "fax_number": "504-885-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODRIGUEZ CLINIC AND FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-455-2002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "202660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1075353",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.