Robin Renee Childress-Rodriguez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN141373 Issued in GA

Practice address

690 Dallas Hwy
Ste 101
Villa Rica, GA 30180-1264

Phone

(770) 459-0620

Fax

(770) 456-7604

NPI assigned

Jun 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Robin Renee Childress Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1669677498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 7TH ST",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503503",
            "telephone_number": "831-373-6160",
            "fax_number": "831-372-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY",
            "address_2": "STE 101",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801264",
            "telephone_number": "770-459-0620",
            "fax_number": "770-456-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS-RODRIGUEZ",
        "first_name": "ROBIN",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN141373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "CHILDRESS",
            "middle_name": "RENEE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamey S. Chang, DMD
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• Anson Chin
• Stefanie Christopher, APRN, NP-C, FNP-BC
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• Clarity Counseling of West Georgia
• Candie Clark

• Family Nurse Practitioner in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.