Nicole Lynn Rock, ARNP-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

54241 Issued in ID

Practice address

919 W Canfield Ave
Coeur D Alene, ID 83815-9764

Phone

(208) 758-0560

NPI assigned

Apr 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• North Idaho Dermatology, Inc.

  • Dermatology Physician
  • Coeur D Alene, ID
  • NPI 1215936638

  ID

  Medicare reassignment Care Compare group NPD
• Active Family Healthcare PLLC

  • Family Medicine Physician
  • Coeur D Alene, ID
  • NPI 1063764462

  ID

  Medicare reassignment NPD
• Own Family Medicine and Wellness LLC Dba Active Family Healthcare

  • Family Medicine Physician
  • Coeur D Alene, ID
  • NPI 1942116884
  NPD (past)
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984
  NPD (past)

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Idaho Dermatology Inc 16 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1962199075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-758-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-758-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "ARNP-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "54241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ryan Robinson
• Michele Alice Robison, PH.D
• Madison Amelia Robnett
• Amanda Dee Roby, N.P.
• Ellen Kay Rock, ARNP
• Maria R Rodebaugh, MD
• Deborah Rodgers, LCSW
• Jason Baltar Rodulfa, MD
• Michelle Roff, PHARMD
• Roger C Ehlert, PHD PA

• All providers in Coeur D Alene, ID
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.