Active NPI
Nicole Roetman, ARNP
- Nurse Practitioner
- Des Moines, IA
National Provider Identifier
1679560296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 094645
- Practice address
- 1801 Hickman Rd
Des Moines, IA 50314-1505 - Phone
- (515) 282-2319
- Fax
- (515) 282-3234
- NPI assigned
- Sep 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 094645 | IA | Primary |
Addresses
Primary practice location
1801 Hickman Rd
Des Moines, IA 50314-1505
Mailing address
1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-2319
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0354 | SD | MD | Occupational Therapist |
| 094645 | IA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679560296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141505",
"telephone_number": "515-282-2319",
"fax_number": "515-282-3234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141505",
"telephone_number": "515-282-2319",
"fax_number": "515-282-3234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROETMAN",
"first_name": "NICOLE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "094645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.