LUIS RODRIGUEZ (NPI# 1639658248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639658248 |
| Entity Type | Individual |
| Full Name | LUIS RODRIGUEZ |
| Credential | MS |
| Practice Address |
1400 Eas Terry Dr Bldg 63 Garrison Hall 5th Floor Pocatello ID 83209-0001 |
| Mailing Address |
605 S 19th Ave Pocatello ID 83201-3461 |
| Practice Telephone | 2082822129 |
| Mailing Telephone | 2082415246 |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 465 Memorial Dr, Pocatello, ID 832014008 | 2082344700 | |
| 605 S 19th Ave, Pocatello, ID 832013461 | 2082415246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972001980 | Luis Rodriguez Jr. | Social Worker | 3914 W Newton Ave, Visalia, CA 93291-8994 | 2018-01-24 |
| 1548700099 | Luis E Rodriguez | Chiropractor | Ab1 Calle Reina Isabel Local 1, Urb Bairoa, Caguas, PR 00727 | 2017-03-02 |
| 1134675036 | Luis Raul Rodriguez | Radiologic Technologist | 9056 Sw 148th Ct, Miami, FL 33196-4119 | 2016-08-30 |
| 1740654003 | Luis Alejandro Rodriguez | Specialist/Technologist, Other | 1134 Nw 183rd Ter, Pembroke Pines, FL 33029-3666 | 2015-11-23 |
| 1770955858 | Luis R Rodriguez | Student in an Organized Health Care Education/Training Program | 22 La Reserva Los Prados Guilarte, Caguas, PR 00726 | 2015-10-28 |
| 1104200997 | Luis Rodriguez | Military Health Care Provider | Uss Bremerton # 698, Fpo, AP 96661-2378 | 2015-07-13 |
| 1659791192 | Luis Alberto Rodriguez | Psychologist | 117 Calle Diosdado, Bo. Coco Nuevo, Salinas, PR 00751 | 2014-04-23 |
| 1043659972 | Luis Mauricio Rodriguez | Dentist | 17030 El Camino Real, Houston, TX 77058-2630 | 2013-06-25 |
| 1326284514 | Luis Javier Rodriguez | Nurse Practitioner | 26103 Glenbriar Spring Ln, Cypress, TX 77433-1355 | 2008-12-18 |
| 1760632210 | Luis Manuel Rodriguez | Dentist | Calle 4ta Diaz Miron 8084, Zona Centro, Tijuana, BC 22000 | 2008-09-21 |
| Street Address |
1400 EAS TERRY DR BLDG 63 GARRISON HALL 5TH FLOOR |
| City | POCATELLO |
| State | ID |
| Zip Code | 83209-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093097081 | Eydie Kendall | Physical Therapist | 1400 Terry Drive, Pocatello, ID 83209 | 2011-09-15 |
| 1548548589 | Corrie Elizabeth Holmes | Audiologist | 650 Memorial Drive Building 68, Pocatello, ID 83209 | 2011-07-25 |
| 1730351081 | Idaho State University | Pharmacy | 990 South 8th, Pocatello, ID 83209 | 2008-03-27 |
| 1922204551 | Melody Ann Weaver | Nurse Practitioner | 921 S 8th Ave Stop 8101, Pocatello, ID 83209 | 2007-06-21 |
| 1710482500 | Ashley Letson | Specialist/Technologist | 921 S 8th Ave, Mcintosh Manor D9, Pocatello, ID 83209 | 2018-03-26 |
| 1407261407 | Stephen B Grandy | Dentist | 465 Memorial Drive, Pocatello, ID 83209-0000 | 2014-06-27 |
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1174149389 | Santiago A Segura Barron | Specialist/Technologist | Holt Arena 550 Memorial Drive Building 50, Pocatello, ID 83209-0001 | 2020-06-23 |
| 1205384484 | Max Esposito | Physical Medicine & Rehabilitation | 1400 E Terry Dr, Pocatello, ID 83209-0001 | 2016-09-15 |
| 1306022041 | Kelly Elizabeth Thompson | Occupational Therapist | Department of Physical and Occupational Therapy, Mail Stop 8045, Pocatello, ID 83209-0001 | 2008-01-11 |
| Find all providers in zip 83209 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023287612 | Steven Randall Lawyer | Psychologist | Idaho State University, Department of Psychology, Stop 8112, Pocatello, ID 83209-8112 | 2008-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861039943 | Corinne Patricia Bottrell | Psychologist | 547 S Fitness Pl Ste 110, Eagle, ID 83616-6552 | 2019-12-07 |
| 1700220209 | Colton D. Miller | Psychologist | 231 Student Health & Counseling Bldg, Rexburg, ID 83460-2020 | 2013-04-26 |
| 1730200460 | Pro Active Advantage, LLC | Psychologist | 215 University Dr, Gooding, ID 83330-6155 | 2007-04-02 |
Please comment or provide details below to improve the information on LUIS RODRIGUEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.