Individual provider Active NPI

Rummy Rodriguez, CSWA

  • Clinical Social Worker
  • Roseburg, OR
National Provider Identifier
1740942937
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1299 NW Ellan Street Uite 2
Roseburg, OR 97471-8091
Phone
(949) 514-3658
NPI assigned
Oct 6, 2021
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1299 NW Ellan Street Uite 2
Roseburg, OR 97471-8091

Mailing address

2958 Tumblewood GRV
Colorado Springs, CO 80910-4470
Phone (458) 802-3883

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umpqua Family Therapy LLC CurrentSince Oct 10, 2021 Accepting new patients

Locations

1000 SE Stephens St
Roseburg, OR 97470
Phone (541) 900-1418

1299 NW Ellan St
Ste 2
Roseburg, OR 97470
Phone (458) 802-3883

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26492/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1740942937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2958 TUMBLEWOOD GRV",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809104470",
            "telephone_number": "458-802-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 NW ELLAN STREET UITE 2",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718091",
            "telephone_number": "949-514-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RUMMY",
        "credential": "CSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.