MR. JOSE ABRAHAM RODRIGUEZ (NPI# 1780779579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780779579 |
| Entity Type | Individual |
| Full Name | MR. JOSE ABRAHAM RODRIGUEZ |
| Credential | MD |
| Practice Address |
702 Martin Luther King St Mound Bayou MS 38762-9314 |
| Mailing Address |
409 Carroll St Picayune MS 39466-2607 |
| Practice Telephone | 6627418800 |
| Practice Fax Number | 6627412700 |
| Mailing Telephone | 6017985227 |
| Mailing Fax Number | 6017985271 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 19905 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09151072 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 409 Carroll St, Picayune, MS 394662607 | 6017985227 | 6017985271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366053365 | Jose Rodriguez | Chiropractor | 39 Jay St Apt 2, Newark, NJ 07103-3259 | 2020-08-12 |
| 1396356788 | Jose R Rodriguez | Phlebology | 330 W 9th St Ste 5, Hialeah, FL 33010-3865 | 2020-08-11 |
| 1003455429 | Jose Rodriguez | Community Health Worker | 6345 Perkins St, Detroit, MI 48210-2466 | 2020-01-02 |
| 1538710124 | Jose Rodriguez | Technician | 4023 Puffer Trce Apt 44d, Spring Hill, FL 34609-0521 | 2019-09-25 |
| 1851860043 | Jose Rodriguez | Community/Behavioral Health | 514 Atkinson Way, El Paso, TX 79915-2600 | 2018-11-16 |
| 1063920585 | Jose G Rodriguez | Counselor | 300 Urb. Hacienda Concordia, Santa Isabel, PR 00757 | 2018-01-18 |
| 1841706421 | Jose Luis Rodriguez | Massage Therapist | 177 Ave De Diego, San Juan, PR 00927-6310 | 2017-12-19 |
| 1942711072 | Jose Lorenzo Rodriguez | Non-emergency Medical Transport (VAN) | 1898 Nw 69th St, Miami, FL 33147-6914 | 2017-10-16 |
| 1598284820 | Jose Angel Rodriguez Jr. | Nurse Practitioner | Informe Healthcare In, LLC, 8800 Virginia Pl, Merrillville, IN 46410-7109 | 2017-09-19 |
| 1861921991 | Jose L Rodriguez | Psychologist | 1260 N Dutton Ave Ste 225, Santa Rosa, CA 95401-7156 | 2017-06-12 |
| Street Address |
702 MARTIN LUTHER KING ST |
| City | MOUND BAYOU |
| State | MS |
| Zip Code | 38762-9314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104848787 | Delta Health Center | Clinic/Center | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2006-07-24 |
| 1053921320 | Sarah Shepherd | Counselor | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2020-08-03 |
| 1043841067 | Anthony Louis Oliveri | Physical Medicine & Rehabilitation | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2020-01-29 |
| 1295290872 | Laura Grant | Clinical Exercise Physiologist | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2019-02-07 |
| 1730602806 | Simone Shardae Williams Moore | Pediatrics | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2017-07-20 |
| 1467999318 | Kirsten Westerfield | Dietitian, Registered | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2017-01-30 |
| 1477090728 | Meta H Anderson | Nurse Practitioner | 702 Martin Luther King St, Pob 900, Mound Bayou, MS 38762-9314 | 2017-01-25 |
| 1124474648 | Natural Pain Back Institute, LLC | Chiropractor | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2016-05-13 |
| 1285041038 | Ronsheka A Palmer | Nurse Practitioner | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2014-07-14 |
| 1831523620 | Alyssa Lott Simmons | Nurse Practitioner | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2013-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891137873 | Beverly C Johnson | Hospice Care, Community Based | 116 S Edward Avenue, Mound Bayou, MS 38762 | 2013-07-19 |
| 1629310487 | Community Adult Day Care | Clinic/Center | 114 S Edwards Avenue, Mound Bayou, MS 38762 | 2013-03-20 |
| 1235482233 | Melvern Scott Jr. | Social Worker | 109 Rayner Rd, Mound Bayou, MS 38762 | 2012-10-16 |
| 1063692770 | Allison Hailman Doyle | Family Medicine | 702 Mlk St, Mound Bayou, MS 38762 | 2007-11-09 |
| 1578785820 | Mound Bayou Public Schools | Registered Nurse | 202 Mlk, Mound Bayou, MS 38762 | 2007-05-03 |
| 1700923836 | Delta Health Center | Clinic/Center | 702 Martin Luther King Rd, Mound Bayou, MS 38762 | 2007-01-30 |
| 1649363656 | Ki M Chang | Internal Medicine | 7165 Getwell Road, Bldg F, Southaven, MS 38762 | 2006-10-02 |
| 1689033706 | North Bolivar Consolidated School District | Local Education Agency (LEA) | 201 Green St, Mound Bayou, MS 38762 | 2016-02-17 |
| 1144398710 | Delta Health Center | Clinic/Center | 702 Martin Luther King Road, Mound Bayou, MS 38762 | 2006-12-01 |
| 1255545570 | Delta Health Center, Inc. | Clinic/Center | 702 Martin Luther King Road, Mound Bayou, MS 38762-0900 | 2007-05-09 |
| Find all providers in zip 38762 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730602806 | Simone Shardae Williams Moore | Pediatrics | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2017-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464181 | Meredith Sanford | Pediatrics | 101 Farm View Dr, Oxford, MS 38655-7728 | 2020-10-15 |
| 1255947297 | Gluckstadt Tc Kids, LLC | Pediatrics | 101 Lexington Dr Ste A, Madison, MS 39110-6986 | 2020-09-16 |
| 1982224895 | Vpa PC | Pediatrics | 111 E Capitol St Ste 215, Jackson, MS 39201-2108 | 2020-04-21 |
| 1992356166 | Marcie P Errington | Pediatrics | 3110 Sumrall Rd, Crystal Springs, MS 39059-8955 | 2019-09-27 |
| 1235635566 | North Mississippi Medcial Center, Inc. | Pediatrics | 1150 S Green St Ste D, Tupelo, MS 38804-4901 | 2018-04-04 |
| 1538675798 | The Pedz Clinic | Pediatrics | 610 3rd St Sw, Magee, MS 39111-3994 | 2017-12-22 |
| 1841715539 | Happicare One LLC Ppec Pediatric Daycare | Pediatrics | 213 W Park Ave, Greenwood, MS 38930-3008 | 2017-08-03 |
| 1336598028 | Andrea Logan Md | Pediatrics | 3631 Bienville Blvd Ste B, Ocean Springs, MS 39564-5702 | 2016-06-03 |
| 1730541640 | Stephanie Harrell | Pediatrics | 309 Llewellyn Ave, Mccomb, MS 39648-2703 | 2016-03-22 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
| Find all providers with the same taxonomy | ||||
| City | MOUND BAYOU |
| Zip Code | 38762 |
Please comment or provide details below to improve the information on MR. JOSE ABRAHAM 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.