Traci Rodriguez, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

577500 Issued in TX

Practice address

3516 22ND PL
Lubbock, TX 79410-1316

Phone

(806) 771-1386

Fax

(806) 771-1388

NPI assigned

Jul 4, 2006

Last updated

Jan 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Traci Garcia Former name

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

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hima B Ravi, M.D., P.a.Group PAC ID 6709270689, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Falcon South Plains Hospice LP

  dba Excelacare Hospice

  • Community Based Hospice Care Agency
  • Lubbock, TX
  • NPI 1902004500

  Limited Partnership Interest

  CMS ownership
• Falcon South Plains Hospice, LP

  dba Interim Hospice of Granbury

  • Community Based Hospice Care Agency
  • Waco, TX
  • NPI 1144525700

  Limited Partnership Interest

  CMS ownership
• Falcon South Plains Hospice, LP

  dba Excelacare Hospice

  • Community Based Hospice Care Agency
  • Midland, TX
  • NPI 1568695617

  Limited Partnership Interest

  CMS ownership

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.

• Hima B Ravi, M.D., P.a.

  • Internal Medicine Physician
  • Lubbock, TX
  • NPI 1700530052

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Enrique Rodriguez, M.D., P.a.

  • Internal Medicine Physician
  • Lubbock, TX
  • NPI 1467482182

  Nurse Practitioner

  Medicare reassignment NPD
• MTR Management Group LLC

  dba Bender Terrace

  • Skilled Nursing Facility
  • Lubbock, TX
  • NPI 1306221247
  NPD
• Juan Carlos de la Cerda

  dba Sono Diagnostics of West Texas

  • Other Technician
  • Lubbock, TX
  • NPI 1033282629
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1659301471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54136",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794534136",
            "telephone_number": "806-771-1386",
            "fax_number": "806-771-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101316",
            "telephone_number": "806-771-1386",
            "fax_number": "806-771-1388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8212 Ithaca Ave Ste E1",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794232633",
            "country_code": "US",
            "telephone_number": "806-687-6336",
            "fax_number": "806-771-1388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "TRACI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "577500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00090182",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00317552",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00216190",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124233109",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141133204",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y0236",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141133203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "GARCIA",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robertah Rodriguez
• Samantha Rodriguez, RBT
• Samantha Dominque Rodriguez
• Shonda Hope McCay Rodriguez, PHARM.D.
• Tammy Faye Rodriguez, LCDC-I
• Amanda Price Rodriquez, PT
• Lindsay Rodriquez
• Jerri Roemer, PTA
• Roger D Tipton DDS, Ms, PA
• Roger J. Wolcott, M.D., P.a.

• Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.