Samuel William Rodriguez

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

8694 Issued in AZ

Practice address

4140 E Baseline Rd Ste 101
Mesa, AZ 85206-4413

Phone

(480) 233-9505

NPI assigned

May 1, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1639667009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-233-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-233-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SAMUEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8694",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "AZ",
            "license": "8694",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "8694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Alexander Rodriguez, DNAP, CRNA
• Juan Antonio Rodriguez
• Julianna Rodriguez, MC, LAC
• Marisela Rodriguez
• Nohora Liliana Rodriguez
• Tara Lyn Rodriguez, MS, LAC
• Kaleigh Marie Roeder, OTR
• Tamara Lee Roehling, PT
• Richard Roger, CRNA
• Ben Rogers

• Rehabilitation Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Rehabilitation Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.