Active NPI
Carlos H Rodriguez, M.D.
- Surgery Physician
- Grand Rapids, MI
National Provider Identifier
1700971546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 043669
- Practice address
- 1900 Wealthy St SE
Suite 180
Grand Rapids, MI 49506-2969 - Phone
- (616) 458-1200
- Fax
- (616) 459-0199
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 043669 | MI | Primary |
Addresses
Primary practice location
1900 Wealthy St SE
Suite 180
Grand Rapids, MI 49506-2969
Mailing address
100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043669 | MI | MD | Surgery Physician |
Interoperability endpoints
- carlos.rodriguez@epic00.shdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1700971546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 WEALTHY ST SE",
"address_2": "SUITE 180",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495062969",
"telephone_number": "616-458-1200",
"fax_number": "616-459-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CARLOS",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "043669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.