Active NPI
Nathaniel David Rodriguez, PHARM D
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1962005264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19651
- Practice address
- 9405 W Russell Rd
Las Vegas, NV 89148-5552 - Phone
- (702) 262-7854
- NPI assigned
- Nov 18, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19651 | NV | Primary |
Addresses
Primary practice location
9405 W Russell Rd
Las Vegas, NV 89148-5552
Mailing address
9405 W Russell Rd
Las Vegas, NV 89148-5552
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19651 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warm Springs Road CVS LLC | Past | Accepting new patients | |
| Warm Springs Road CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1841212545
-
- Pharmacy
- Las Vegas, NV
- NPI 1558460865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1962005264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9405 W RUSSELL RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891485552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9405 W RUSSELL RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891485552",
"telephone_number": "702-262-7854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "NATHANIEL",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-18",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "19651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.