Individual provider Active NPI

Monica Rodriguez, APRN NP-C, PHN, RN

  • Family Nurse Practitioner
  • Shafter, CA
National Provider Identifier
1881875805
Registry record updated Oct 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018557 Issued in CA
Practice address
565 Kern St
Shafter, CA 93263-2133
Phone
(661) 746-4937
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 672219 CA
Physical Therapy Assistant 225200000X AT 4902 CA
Family Nurse Practitioner 363LF0000X 95018557 CA Primary

Addresses

Primary practice location

565 Kern St
Shafter, CA 93263-2133

Mailing address

11509 Garrick CT
Bakersfield, CA 93311-9218
Phone (661) 586-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211101001446 CA Practitioner - Nurse Practitioner 6103214762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanguard Medical CorporationGroup PAC ID 4587881685, 23 clinicians

Practice addresses (Care Compare)

845 7TH St
Wasco, CA 93280-1919
Phone (661) 459-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
672219CAMDCommunity Health Registered Nurse
AT 4902CAMDPhysical Therapy Assistant
95018557CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Medical Corporation Current Accepting new patients
Vanguard Medical Corporation CurrentSince Nov 1, 2021 Accepting new patients
Vanguard Medical Corporation CurrentSince Nov 1, 2021 Accepting new patients
Vanguard Medical Corporation Past Accepting new patients
Jae J. Kim, M.D. Past Accepting new patients

Locations

8150 Hageman Rd
Bakersfield, CA 93312
Phone (661) 459-1010

565 Kern St
Shafter, CA 93263
Phone (661) 746-4937

845 7th St
Wasco, CA 93280
Phone (661) 459-1000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634428800000",
    "number": "1881875805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11509 GARRICK CT",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119218",
            "telephone_number": "661-586-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 KERN ST",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632133",
            "telephone_number": "661-746-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MONICA",
        "name_prefix": "Mrs.",
        "credential": "APRN NP-C, PHN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2021-10-17",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "672219",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 4902",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shafter, CA

Sources for this page

Verify at the official NPI Registry.