Individual provider Active NPI

Julie Rodriguez, PMHNP, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple, TX
National Provider Identifier
1619196714
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1000559 Issued in TX
Practice address
1201 Canyon Creek Dr
Temple, TX 76502-3299
Phone
(254) 410-5102
NPI assigned
Apr 25, 2007
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1000559 TX Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 583418 NY
Community Health Registered Nurse 163WC1500X 583418 NY
Psychiatry Physician 2084P0800X 589994 TX

Addresses

Primary practice location

1201 Canyon Creek Dr
Temple, TX 76502-3299

Mailing address

9002 Sandyford CT
Killeen, TX 76542-6292
Phone (646) 361-2175

Other identifiers 1

IdentifierTypeStateIssuer
583418MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210330000265 TX Practitioner - Nurse Practitioner 1355755083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Psychiatry Institute, LLCGroup PAC ID 8325287501, 5 clinicians

Practice addresses (Care Compare)

12234 Shadow Creek Pkwy
Suite 104
Pearland, TX 77584-7330
Phone (713) 429-5325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
583418NYMDAddiction (Substance Use Disorder) Registered Nurse
589994TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Behavioral Healthcare Hospital Inc Single Specialty CurrentSince Oct 13, 2023 Accepting new patients
Temple Behavioral Healthcare Hospital Inc Single Specialty CurrentSince Oct 13, 2023 Accepting new patients
United Psychiatry Institute, LLC Single Specialty CurrentSince May 1, 2025 Accepting new patients
Texas Behavioral Health PLLC Single Specialty CurrentSince May 1, 2025 Accepting new patients

Locations

5314 Dashwood Dr
Houston, TX 77081
Phone (713) 295-5300

12234 Shadow Creek Pkwy
Ste 104
Pearland, TX 77584
Phone (713) 429-5232

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEBFAD

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1619196714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 SANDYFORD CT",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426292",
            "telephone_number": "646-361-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 CANYON CREEK DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023299",
            "telephone_number": "254-410-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JULIE",
        "credential": "PMHNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1000559",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "583418",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "583418",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "589994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583418",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.