Active NPI
Amanda Rae Rodriguez, APRN, FNP-C
- Nurse Practitioner
- Chandler, AZ
National Provider Identifier
1912590076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 252669
- Practice address
- 1110 S Dobson Rd
Chandler, AZ 85286-6163 - Phone
- (480) 855-3229
- NPI assigned
- Feb 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 252669 | AZ | Primary |
Addresses
Primary practice location
1110 S Dobson Rd
Chandler, AZ 85286-6163
Mailing address
287 W Buena Vista Dr
Tempe, AZ 85284-5270
Phone (602) 690-2713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211129001585 | AZ | Order and Referring Only - Nurse Practitioner | 2668862087 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252669 | AZ | MD | Nurse Practitioner |
Interoperability endpoints
- amandaballnp@119692.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1912590076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "287 W BUENA VISTA DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852845270",
"telephone_number": "602-690-2713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 S DOBSON RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852866163",
"telephone_number": "480-855-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "AMANDA",
"middle_name": "RAE",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-18",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "252669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.