Ricardo Israel Rodriguez

Primary specialty

Social WorkerTaxonomy code 104100000X

License

12366411-3502 Issued in UT

Practice address

151 S University Ave
Provo, UT 84601-4427

Phone

(801) 851-7127

NPI assigned

Dec 28, 2017

Last updated

Dec 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1720594757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 S 1220 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846015470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S UNIVERSITY AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014427",
            "telephone_number": "801-851-7127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 E 12300 S Ste 7",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840209256",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 S 200 E Ste 103",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843023387",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 N Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840741652",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 S Valley Grove Way Ste 160",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840626758",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 W 2230 N",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846047520",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8789 S Highland Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840931605",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4293 S 2700 W Ste 300",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841292144",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3500 Harrison Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844032038",
            "country_code": "US",
            "telephone_number": "801-477-7189",
            "fax_number": "888-745-9274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RICARDO",
        "middle_name": "ISRAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-28",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "12366411-3502",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Rodriguez
• Kimberly Samantha Rodriguez, PMHNP-BC
• Leslie Katherine Bush Rodriguez, SSW
• Mary Rodriguez
• Nereida Rodriguez, RN
• Allan Roe, PH.D.
• Tiffany Roe, M.A., C.M.H.C.
• Cheridy Roeger, CSW
• Anna Noran Rogers
• Anya Carlson Rogers

• Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.