Jose Antonio Rodriguez, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

301 N 1St St BLDG 46
Altus Afb, OK 73523-5005

Phone

(240) 857-5425

NPI assigned

Aug 12, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1699054288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 1ST ST BLDG 46",
            "city": "ALTUS AFB",
            "state": "OK",
            "postal_code": "735235005",
            "telephone_number": "580-481-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 1ST ST BLDG 46",
            "city": "ALTUS AFB",
            "state": "OK",
            "postal_code": "735235005",
            "telephone_number": "240-857-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary John-David Nagle
• Nguyen T Nguyen, PHARMD
• Emily Elizabeth Olinger, DO
• Alexander Todd Parmater, DMD
• Joseph Remsburg
• Jayson Stewart, BA, MSW
• Sandra H Stuart, MS, RDN, CSSD, LD
• Katelin Elise Thai, D.O.
• Brian Jacob Welch

• Independent Duty Medical Technicians in Altus Afb, OK
• Providers in Altus Afb, OK by specialty
• Independent Duty Medical Technicians in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.