Individual provider Active NPI

Jennifer Rodriguez, MS, RD/LD

  • Registered Dietitian
  • Oklahoma City, OK
National Provider Identifier
1881476356
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2843 Issued in OK
Practice address
3555 NW 58TH St Ste 910-W
Oklahoma City, OK 73112-4707
Phone
(405) 885-0270
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2843 OK Primary

Addresses

Primary practice location

3555 NW 58TH St Ste 910-W
Oklahoma City, OK 73112-4707

Mailing address

12911 E 32ND St
Tulsa, OK 74134-3209
Phone (918) 407-2023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240320002461 OK Practitioner - Registered Dietitian Or Nutrition Professional 5799122255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2843OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Well Rooted Health and Nutrition CurrentSince Mar 4, 2024 Accepting new patients

Locations

3555 NW 58th St
Ste 910W
Oklahoma City, OK 73112
Phone (405) 653-9161

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1881476356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 E 32ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741343209",
            "telephone_number": "918-407-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST STE 910-W",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124707",
            "telephone_number": "405-885-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JENNIFER",
        "credential": "MS, RD/LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.