Active NPI
Conrado Rodriguez, PH.D.
- Psychologist
- Omaha, NE
National Provider Identifier
1982752093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 616
- Practice address
- 1311 S 9TH St
Omaha, NE 68108-3629 - Phone
- (402) 210-9393
- Fax
- (402) 339-4709
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 616 | NE | Primary |
| Psychologist | 103T00000X | PY6741 | FL |
Addresses
Primary practice location
1311 S 9TH St
Omaha, NE 68108-3629
Mailing address
15822 S 63Rd St
Papillion, NE 68133-2651
Phone (402) 212-4409
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 249021 | Other | NE | MIDLANDS CHOICE |
| 10025231300 | Medicaid | NE | |
| 80012 | Other | NE | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 616 | NE | MD | Professional Counselor |
| PY6741 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1982752093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15822 S 63RD ST",
"city": "PAPILLION",
"state": "NE",
"postal_code": "681332651",
"telephone_number": "402-212-4409",
"fax_number": "402-339-4709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 S 9TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681083629",
"telephone_number": "402-210-9393",
"fax_number": "402-339-4709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CONRADO",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "616",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY6741",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "249021",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025231300",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "80012",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.