Individual provider Active NPI

Leslie Ray Rodriguez, RN, ACNS-BC, APRN

  • Clinical Nurse Specialist
  • Dallas, TX
National Provider Identifier
1871849042
Registry record updated Jul 25, 2012
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Mar 19, 2020.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
522482 Issued in TX
Practice address
3500 Gaston Avenue
Dallas, TX 75246-2026
Phone
(214) 820-0111
Fax
(214) 865-1580
NPI assigned
Jul 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered Nurse 163WP0000X 522482 TX
Clinical Nurse Specialist 364S00000X 522482 TX Primary
Adult Health Clinical Nurse Specialist 364SA2200X 522482 TX

Addresses

Primary practice location

3500 Gaston Avenue
Dallas, TX 75246-2026

Mailing address

3500 Gaston Avenue
Dallas, TX 75246-2026
Phone (214) 865-1573

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
522482TXMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1871849042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVENUE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462026",
            "telephone_number": "214-865-1573",
            "fax_number": "214-865-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVENUE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462026",
            "telephone_number": "214-820-0111",
            "fax_number": "214-865-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LESLIE",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "RN, ACNS-BC, APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "TX",
            "license": "522482",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "522482",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "522482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.