Active NPI
Doris Jean Rodriguez, PHD, RN, C-PNP/PC
- Pediatric Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1740451129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN123156
- Practice address
- 1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653 - Phone
- (404) 523-6571
- NPI assigned
- Mar 13, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN123156 | GA | Primary |
Addresses
Primary practice location
1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653
Mailing address
105 Putmans Head
Peachtree City, GA 30269-1238
Phone (770) 843-8787
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
- Credentials
- Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN123156 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Good Samaritan Health Center, Inc. | Current | Accepting new patients | |
| Hope First Investments | Current | Accepting new patients |
Locations
1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318
Phone (404) 523-6571
Interoperability endpoints
- jeannie.rodriguez.1@6806.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Atlanta, GA
- NPI 1629254008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1740451129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 PUTMANS HEAD",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302691238",
"telephone_number": "770-843-8787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303186653",
"telephone_number": "404-523-6571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DORIS",
"middle_name": "JEAN",
"credential": "PHD, RN, C-PNP/PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-13",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN123156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.