Individual provider Active NPI

Natalie Rodriguez, NP

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1609273077
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012245 Issued in IL
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(219) 308-8148
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012245 IL Primary

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Other practice location 1

3700 W 103rd St
Chicago, IL 60655-3105
Phone (773) 298-3712

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209012245ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Xavier University PastSince Nov 8, 2016 Accepting new patients

Organizations & group practices 1

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1609273077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "219-308-8148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 W 103rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606553105",
            "country_code": "US",
            "telephone_number": "773-298-3712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NATALIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.