Individual provider Active NPI

Maritza Rodriguez, DSC, MA,BA,ATC

  • Athletic Trainer
  • Green Valley, AZ
National Provider Identifier
1902866197
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2255A2300X Issued in AZ
Practice address
275 W Continental Rd
Suite #181 E/F
Green Valley, AZ 85622-3624
Phone
(520) 625-1622
Fax
(520) 625-1655
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2255A2300X AZ Primary

Addresses

Primary practice location

275 W Continental Rd
Suite #181 E/F
Green Valley, AZ 85622-3624

Mailing address

275 W Continental Rd
Suite 181-E/F
Green Valley, AZ 85622-3624
Phone (520) 625-1622

Other identifiers 1

IdentifierTypeStateIssuer
22OtherAZRESPIRATORY,REHABILITATIO

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
Credentials
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
2255A2300XAZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1902866197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W CONTINENTAL RD",
            "address_2": "SUITE 181-E/F",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223624",
            "telephone_number": "520-625-1622",
            "fax_number": "520-625-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W CONTINENTAL RD",
            "address_2": "SUITE #181 E/F",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223624",
            "telephone_number": "520-625-1622",
            "fax_number": "520-625-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARITZA",
        "name_prefix": "Mrs.",
        "credential": "DSC, MA,BA,ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "2255A2300X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESPIRATORY,REHABILITATIO",
            "identifier": "22",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.