Individual provider Active NPI

Nicole Roark, M.D.

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1720533292
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
45445 Issued in TX
Practice address
1 Childrens Way # 203
Little Rock, AR 72202-3500
Phone
(501) 364-3933
Fax
(501) 364-2939
NPI assigned
Aug 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-15641 AR
Pediatric Anesthesiology Physician 207LP3000X E-1561 AR
Anesthesiology Physician 207L00000X 45445 TX Primary

Addresses

Primary practice location

1 Childrens Way # 203
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-6347

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL archildrens.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170222000097 TX Practitioner - Anesthesiology 3173807039 Reassigns benefits to 1 organization
I20220915001674 AR Practitioner - Anesthesiology 3173807039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hendrick Anesthesia NetworkGroup PAC ID 3274521281, 99 clinicians

Practice addresses (Care Compare)

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2000

Hospital & facility affiliations

  • Hendrick Medical Center Hospital, Abilene, TX, CCN 450229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-15641ARMDAnesthesiology Physician
E-1561ARMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Hendrick Anesthesia Network CurrentSince Jul 1, 2025 Accepting new patients
Arkansas Childrens Hospital CurrentSince Aug 1, 2022 Accepting new patients
University of Arkansas for Medical Sciences Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Arkansas Children'S Hospital CurrentSince Aug 1, 2022 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2022 Accepting new patients

Locations

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#203
Little Rock, AR 72202
Phone (501) 364-2180

751 N 18th St
Abilene, TX 79601
Phone (915) 676-0557

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1720533292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 203",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-3933",
            "fax_number": "501-364-2939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775555302",
            "country_code": "US",
            "telephone_number": "409-772-6347",
            "fax_number": "409-772-6409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-15641",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AR",
            "license": "E-1561",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "45445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "archildrens.org",
            "affiliation": "N",
            "address_1": "1 Childrens Way",
            "city": "Little Rock",
            "state": "AR",
            "country_code": "US",
            "postal_code": "722023500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.