Individual provider Active NPI

Timothy Mitchel Roark, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1770052185
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.026312 Issued in OH
Practice address
4130 Dry Ridge Rd
Cincinnati, OH 45252-3014
Phone
(513) 981-5162
NPI assigned
Nov 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.026312 OH Primary

Addresses

Primary practice location

4130 Dry Ridge Rd
Cincinnati, OH 45252-3014

Mailing address

4130 Dry Ridge Rd
Cincinnati, OH 45252-1914
Phone (513) 981-5162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200406003303 OH Practitioner - Nurse Practitioner 4385073774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians

Practice addresses (Care Compare)

4130 Dry Ridge Rd
Cincinnati, OH 45252-1914
Phone (513) 981-5162

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati, LLC CurrentSince May 24, 2020 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince May 24, 2020 Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

4130 Dry Ridge Rd
Cincinnati, OH 45252
Phone (513) 385-6000

Interoperability endpoints

  • Direct secure messaging: troark93078@direct.bsmhealth.org

Organizations & group practices 2

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 5

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": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1770052185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 DRY RIDGE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452521914",
            "telephone_number": "513-981-5162",
            "fax_number": "513-923-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 DRY RIDGE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452523014",
            "telephone_number": "513-981-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "TIMOTHY",
        "middle_name": "MITCHEL",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.