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Mariah Leigh Rodriguez

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821

PECOS Enrollment

This provider is enrolled in PECOS as MARIAH RODRIGUEZ.

Based on the most recent information from CMS, provider Mariah Leigh Rodriguez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1003367541
Provider Type
Individual
Full Name
Rodriguez, Mariah Leigh
Title
Ms.
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
10/19/2016
Last Updated
5/8/2024

Contact Information

Practice Location

11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821

(980) 308-0169

(980) 308-0173

Mailing Location

PO Box 601843, Charlotte, NC 28260-1843

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-07406 North Carolina

Mariah Leigh Rodriguez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Miller, Samantha Marie

O'Connor, William Charles

Kenney, Ethan Raymond

Miller, Hailey

Young, Brenda J.

Ciovacco, Emily C

Aker, Kenna Brooke

Kauer, Lauren Steele

O'Neil, Megan Elizabeth

Lesuer, Hayley Hasty