Jaime Rodriguez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301059475 Issued in MI

Practice address

6701 Paw Paw Ave
Coloma, MI 49038-9519

Phone

(269) 468-6430

NPI assigned

Aug 22, 2005

Last updated

Jan 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1932191202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54581 CALIFORNIA RD",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490479237",
            "telephone_number": "269-782-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 PAW PAW AVE",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389519",
            "telephone_number": "269-468-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAIME",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301059475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104226795",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104264141",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "35-0-14-4904-2",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - GROUP",
            "identifier": "700A460030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruben S Ramdeo
• Red Arrow Family Practice
• Red Arrow Medical Clinic PC
• Rite Aid of Michigan Inc (Rite Aid Pharmacy 04239)
• Shanna R Rodgers, MA
• Ruth Lee Center for Healing and Growth
• Shafee Ahamad Shaik
• Melinda Amber Shannon, PT. DPT, MS
• Jeremy B Shelley, PT
• Faith Shreve, LMSW

• Pediatrics Physician in Coloma, MI
• Providers in Coloma, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.