Keaton D Rodriquez

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

3085 Laurence CT
Idaho Falls, ID 83402-5507

Phone

(120) 852-0024

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1861975294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 LAURENCE CT",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025507",
            "telephone_number": "120-852-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 LAURENCE CT",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025507",
            "telephone_number": "120-852-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIQUEZ",
        "first_name": "KEATON",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Rodriguez-Moncada
• Alexandra Rodriguez, MS, SLP
• Aracelli Rodriguez, B.A.
• Carmelita Rodriguez
• Oryan Rodriguez, BSW
• Randy Rodriquez
• Roger H. Tall M.D. P.a.
• Roger S. Brunt M.D. P.a.
• Jamille Baxter Rogers, LPC
• Ronald Wilson Rogers, BA

• Athletic Trainer in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.