Individual provider Active NPI

Joshua Allen Rodgers, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1801150289
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22347 Issued in CA
Practice address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone
(858) 859-1188
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22347 CA Primary

Addresses

Primary practice location

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Mailing address

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (858) 858-1188

Other practice location 1

18520 Via Princessa C-2A
Canyon Country, CA 91387-8326
Phone (661) 424-9000

Other practice location 2

5717 Pacific Center Blvd Ste 200
San Diego, CA 92121
Phone (858) 859-1188

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

State licenses

LicenseStateTypeSpecialty
PA22347CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1801150289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-858-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18520 Via Princessa C-2A",
            "address_purpose": "LOCATION",
            "city": "Canyon Country",
            "state": "CA",
            "postal_code": "913878326",
            "country_code": "US",
            "telephone_number": "661-424-9000",
            "fax_number": "661-424-0808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 Pacific Center Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92121",
            "country_code": "US",
            "telephone_number": "858-859-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "JOSHUA",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.