Individual provider Active NPI

Connie Marie Thomas, DNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1699499384
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
218965 Issued in AR
Practice address
5309 W Village Pkwy Ste 3
Rogers, AR 72758-8102
Phone
(479) 275-4152
Fax
(479) 227-6811
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 218965 AR
Nurse Practitioner 363L00000X 218965 AR
Adult Health Nurse Practitioner 363LA2200X 218965 AR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 218965 AR Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023000802 MO
Nurse Practitioner 363L00000X 2023000802 MO

Addresses

Primary practice location

5309 W Village Pkwy Ste 3
Rogers, AR 72758-8102

Mailing address

PO Box 205
Bentonville, AR 72712-0205
Phone (618) 554-8730

Other practice location 1

6815 Isaacs Orchard Rd Ste C
Springdale, AR 72762-6285
Phone (479) 301-5290

Other identifiers 2

IdentifierTypeStateIssuer
294786758MedicaidAR
420119243MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230111000605 AR Practitioner - Nurse Practitioner 5496125387
I20230120000322 MO Practitioner - Nurse Practitioner 5496125387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.1 of 100Reported as group
Quality
82.5
Promoting interoperability
100
Improvement activities
40
Cost
81.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218965ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Fig, PLLC Adult Health CurrentSince Nov 9, 2025 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince Sep 20, 2025 Accepting new patients
Wild Fig, LLC Psychiatric/Mental Health CurrentSince Dec 15, 2024 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Nov 3, 2024 Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients
Eustasis Foundation, Inc PastSince Aug 30, 2020 Accepting new patients
Day by Day: a Center for Health and Healing Past Accepting new patients
St. Vincent Medical Group Nurse Practitioner PastSince Oct 1, 2022 Accepting new patients

Locations

215 N College Ave
Fayetteville, AR 72701
Phone (479) 301-5290

5309 W Village Pkwy
Ste 3
Rogers, AR 72758
Phone (479) 275-4152

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767

9191 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 491-6190

904 E 68th St
Kansas City, MO 64131
Phone (816) 333-5485

4301 NE Parvin Rd
North Kansas City, MO 64117
Phone (816) 444-0900

2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966

505 W Evergreen St
Strafford, MO 65757
Phone (417) 736-9332

809 W Benton St
Windsor, MO 65360
Phone (660) 467-3102

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAHJDD/Endpoint/JAHJDD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1699499384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120205",
            "telephone_number": "618-554-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 W VILLAGE PKWY STE 3",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588102",
            "telephone_number": "479-275-4152",
            "fax_number": "479-227-6811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6815 Isaacs Orchard Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727626285",
            "country_code": "US",
            "telephone_number": "479-301-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "credential": "DNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "218965",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "218965",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "218965",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "218965",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023000802",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023000802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294786758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420119243",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.