Active NPI
Cheryl A Rodriguez, LPN
- Licensed Practical Nurse
- Racine, WI
National Provider Identifier
1669528873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 11232-031
- Practice address
- 720 Chicago St
Racine, WI 53405-2648 - Phone
- (262) 634-3558
- NPI assigned
- Jan 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 11232-031 | WI | Primary |
Addresses
Primary practice location
720 Chicago St
Racine, WI 53405-2648
Mailing address
9312 S 33Rd St
Franklin, WI 53132-9153
Phone (414) 761-9518
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3927648400 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11232-031 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669528873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9312 S 33RD ST",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531329153",
"telephone_number": "414-761-9518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 CHICAGO ST",
"city": "RACINE",
"state": "WI",
"postal_code": "534052648",
"telephone_number": "262-634-3558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CHERYL",
"middle_name": "A",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": "11232-031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3927648400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.