KIMBERLY SAMANTHA RODRIGUEZ PMHNP-BC
NPI 1992659767
Nurse Practitioner - Psychiatric/Mental Health in Provo, UT
About Kimberly Samantha Rodriguez Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY SAMANTHA RODRIGUEZ PMHNP-BC (NPI 1992659767) is an individual psychiatric/mental health provider in Provo, Utah, licensed in Utah (11415541-8900) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Samantha Rodriguez Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PROVO, UT 84604
PROVO, UT 84604
PROVO, UT 84604
PROVO, UT 84604
PROVO, UT 84604
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Rodriguez's NPI number?
The NPI number for Kimberly Rodriguez is 1992659767. It was assigned to this individual provider in the NPPES registry on February 26, 2026. The provider is also known as Samantha Rodriquez.
Where is Kimberly Rodriguez located?
Kimberly Rodriguez practices at 395 W Cougar Blvd Ste 601, Provo, UT 84604. The listed phone number is (801) 357-7525.
What is Kimberly Rodriguez's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Kimberly Rodriguez enrolled in Medicare?
Yes. Kimberly Rodriguez is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kimberly Rodriguez was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly Samantha Rodriguez, PMHNP-BC · NPI 1992659767
Psychiatric/Mental Health physician in Provo, Utah. Individual provider, active in the CMS NPPES registry since February 26, 2026.
## Identity
- **NPI:** 1992659767 (Entity type: Individual)
- **Enumerated:** February 26, 2026
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 11415541-8900 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 395 W COUGAR BLVD STE 601, Provo, UT 84604-3331
- **Phone:** (801) 357-7525
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** September 2, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1992659767) · Data from the CMS NPPES public registry.