Individual provider Active NPI

Erika V Rodriguez, COTA

  • Personal Care Attendant
  • Jacksonville, FL
National Provider Identifier
1922536358
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
100062450 Issued in FL
Practice address
4101 Southpoint Dr E
Jacksonville, FL 32216-0996
Phone
(904) 296-6800
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA14937 FL
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X 100062450 FL Primary

Addresses

Primary practice location

4101 Southpoint Dr E
Jacksonville, FL 32216-0996

Mailing address

32 Prattwood LN
Palm Coast, FL 32164-4747
Phone (386) 793-9858

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

State licenses

LicenseStateTypeSpecialty
OTA14937FLMDOccupational Therapy Assistant
100062450FLMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1922536358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PRATTWOOD LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321644747",
            "telephone_number": "386-793-9858",
            "fax_number": "386-864-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996",
            "telephone_number": "904-296-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ERIKA",
        "middle_name": "V",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA14937",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "FL",
            "license": "100062450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.