Jacob Rogier, DNP, CPNP-PC

Individual provider Active NPI Pediatric Nurse Practitioner · Little Rock Afb, AR

NPI 1043087455 · NPPES record last updated Oct 20, 2025

Key facts

NPI
1043087455
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
272006 (AZ)
Practice address
1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone
(501) 987-3080
NPI assigned
Dec 6, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251031003370 AZ Order and Referring Only - Nurse Practitioner 8820587520

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
272006AZMDPediatric Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 272006 AZ Yes

Addresses

Primary practice location

1090 Arnold Dr
Little Rock Afb, AR 72099-4933

Mailing address

1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone (501) 987-3080

Other providers in Little Rock Afb, AR

All providers in Little Rock Afb, AR · Pediatric Nurse Practitioner in Arkansas

Sources for this page

Verify at the official NPI Registry.