Miguel Antonio Rodriguez Jr., IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

690 Barnes Blvd
Joint Base Lewis McChord, WA 98438-1303

Phone

(180) 040-4450

NPI assigned

Dec 16, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1982175113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19330 18TH AVENUE CT E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BARNES BLVD",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984381303",
            "telephone_number": "180-040-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANTONIO",
        "name_suffix": "Jr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Otto Richardson
• Garrett Ripoll, D.O.
• Vanessa Rivera, MD
• Daniel Lawrence Rodkey, M.D.
• Aimee Rodriguez, MA
• Micol Rebecca Rohr, LMP
• Christopher Randall Rohrbough, M.D.
• Samantha Rongstad, RDN
• Cesar Jose Rosa, D.O.
• Callie Roseland

• Independent Duty Medical Technicians in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Independent Duty Medical Technicians in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.