Individual provider Active NPI

Nicholas John Casey Rodriguez, AG-ACNP

  • Acute Care Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1710376165
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2020018088 Issued in MO
Practice address
1001 S Horsebarn Rd
Rogers, AR 72758-8184
Phone
(479) 273-7700
Fax
(479) 273-7753
NPI assigned
Jan 22, 2015
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ATP-000747 AR
Acute Care Nurse Practitioner 363LA2100X 2020018088 MO Primary

Addresses

Primary practice location

1001 S Horsebarn Rd
Rogers, AR 72758-8184

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (479) 273-7700

Other practice location 1

2790 Clay Edwards Dr Ste 625
North Kansas City, MO 64116-3278
Phone (816) 455-3990

Other identifiers 1

IdentifierTypeStateIssuer
394391ZMTFOtherARPROVIDER TRANSACTION ACCESS NUMBER (PTAN)

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
I20150309000298 AR Practitioner - Nurse Practitioner 1355667429 Reassigns benefits to 3 organizations
I20200728002758 MO Practitioner - Nurse Practitioner 1355667429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, shared by 5 NPIs, 314 clinicians
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

1001 S Horsebarn Rd
Rogers, AR 72758-8184
Phone (479) 273-7700

2710 S Rife Medical LN
Rogers, AR 72758-1452

2790 Clay Edwards Dr
Suite 625
North Kansas City, MO 64116-3278
Phone (816) 455-3990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ATP-000747ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Mar 1, 2026 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Mar 1, 2026 Accepting new patients
Meritas Health Corporation CurrentSince Sep 20, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Mar 1, 2026 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Mar 1, 2026 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation CurrentSince Sep 20, 2020 Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

1001 S Horsebarn Rd
Rogers, AR 72758
Phone (479) 273-7700

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681

2790 Clay Edwards Dr
Ste 600
North Kansas City, MO 64116
Phone (816) 561-3003

2790 Clay Edwards Dr
Ste 625
North Kansas City, MO 64116
Phone (816) 421-3115

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1710376165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-273-7700",
            "fax_number": "479-273-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S HORSEBARN RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588184",
            "telephone_number": "479-273-7700",
            "fax_number": "479-273-7753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Clay Edwards Dr Ste 625",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163278",
            "country_code": "US",
            "telephone_number": "816-455-3990",
            "fax_number": "816-455-5351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN CASEY",
        "name_prefix": "Mr.",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "ATP-000747",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2020018088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "394391ZMTF",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.