Active NPI
Kelly M Rodriguez
- Social Worker
- Albuquerque, NM
National Provider Identifier
1831547892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- X-09535
- Practice address
- 5203 Juan Tabo Blvd NE
Ste 2 a
Albuquerque, NM 87111-2683 - Phone
- (505) 266-6121
- NPI assigned
- Jun 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | X-09535 | NM | Primary |
Addresses
Primary practice location
5203 Juan Tabo Blvd NE
Ste 2 a
Albuquerque, NM 87111-2683
Mailing address
5203 Juan Tabo Blvd NE
Ste 2 a
Albuquerque, NM 87111-2683
Phone (505) 266-6121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5818 D Harbour View Blvd
Suite 250
Suffolk, VA 23435-2658
Phone (757) 673-5890
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X-09535 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lswhb LLC | Current | Accepting new patients |
Locations
5818D Harbour View Blvd
Unit 250
Suffolk, VA 23435
Phone (513) 752-8000
Interoperability endpoints
- ethoscareinc.kellyrodriguez@151221.advancedmd-direct.com
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1831547892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5203 JUAN TABO BLVD NE",
"address_2": "STE 2 A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112683",
"telephone_number": "505-266-6121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5203 JUAN TABO BLVD NE",
"address_2": "STE 2 A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112683",
"telephone_number": "505-266-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KELLY",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-01",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "X-09535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.