MR. NICHOLAS JOHN CASEY RODRIGUEZ AG-ACNP NPI 1710376165

NPI Information

NPI: 1710376165
Provider Name: MR. NICHOLAS JOHN CASEY RODRIGUEZ, AG-ACNP
Classification: Nurse Practitioner - 363LA2100X
Specialization: Acute Care
Entity Type: Individual
PECOS Registration: Yes
Address: 2790 CLAY EDWARDS DR STE 625
NORTH KANSAS CITY, MO
ZIP 64116
Phone: (816) 455-3990

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NPI Details

MR. Nicholas John Casey Rodriguez, AG-ACNP is an acute care nurse practitioner in North Kansas City, MO with 11 years of experience. MR. Nicholas John Casey Rodriguez, AG-ACNP NPI is 1710376165. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2790 CLAY EDWARDS DR STE 625
NORTH KANSAS CITY, MO
ZIP 64116-278
Phone: (816) 455-3990
Fax: (816) 455-5351

The NPI 1710376165 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)

The enumeration date for this NPI number is 1/22/2015 and was last updated on 7/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	ATP-000747	ARKANSAS	No
2	363LA2100X	Nurse Practitioner	Acute Care	2020018088	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	394391ZMTF	OTHER	ARKANSAS	PROVIDER TRANSACTION ACCESS NUMBER (PTAN)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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