Individual provider Active NPI

Kristine Elizabeth Rodriguez, OTR

  • Occupational Therapist
  • Mission, TX
National Provider Identifier
1760730287
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
114931 Issued in TX
Practice address
2002 N Conway Ave Ste F
Mission, TX 78572-2926
Phone
(956) 580-4040
Fax
(956) 580-4915
NPI assigned
Aug 15, 2012
Last updated
Aug 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 114931 TX Primary

Addresses

Primary practice location

2002 N Conway Ave Ste F
Mission, TX 78572-2926

Mailing address

2002 N Conway Ave Ste F
Mission, TX 78572-2926
Phone (956) 580-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220921001457 TX Practitioner - Occupational Therapist in Private Practice 3870978232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114931TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Living Home Modifications, LLC. Occupational Therapist CurrentSince Aug 27, 2022 Accepting new patients
Famber Group, LLC Past Accepting new patients

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, 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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1760730287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N CONWAY AVE STE F",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785722926",
            "telephone_number": "956-580-4040",
            "fax_number": "956-580-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 N CONWAY AVE STE F",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785722926",
            "telephone_number": "956-580-4040",
            "fax_number": "956-580-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KRISTINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.