Individual provider Active NPI

Doris Jean Rodriguez, PHD, RN, C-PNP/PC

  • Pediatric Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1740451129
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN123156 Issued in GA
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

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
RN123156GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Good Samaritan Health Center, Inc. CurrentSince Sep 5, 2023 Accepting new patients
Hope First Investments CurrentSince Sep 5, 2023 Accepting new patients

Locations

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318
Phone (404) 523-6571

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.