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Registered Nurse First Assistant: how many are there, and how many are in private practice?

Registered Nurse First Assistants (RNFAs) are perioperative registered nurses who collaborate with surgeons and other members of the healthcare team to support patient outcomes and assist the surgeon during an operation. This page describes the US footprint of NPI records using NUCC taxonomy 163WR0006X as the primary classification, including the national count, state distribution, and share flagged as sole proprietors in NPPES.

National totals

Active NPI records3,096
Registered sole proprietors1,398 (45.2%)
NUCC taxonomy code163WR0006X
GroupingNursing Service Providers

What this specialty covers

A perioperative registered nurse who works in collaboration with the surgeon and other health care team members to achieve optimal outcomes. The RNFA has acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA assists the surgeon.

Reading the sole-proprietor share

For this specialty, 1,398 records, or 45.2%, are flagged as sole proprietors. That field is self-reported in NPPES, so it is an imperfect proxy for private practice and may not capture employment, affiliation, billing, or other organizational arrangements. It should be read as an NPI registration characteristic, not a definitive count of independently practicing RNFAs.

By state

StateActive NPIsSole proprietorsShare
Texas44521548.3%
California31721066.2%
New Jersey27616559.8%
Florida27112746.9%
Georgia1385640.6%
New York1373525.5%
Arizona1356648.9%
Washington1335239.1%
Missouri1204436.7%
Illinois1012625.7%
Oregon975152.6%
Colorado793949.4%
Ohio752837.3%
Pennsylvania592237.3%
Mississippi581220.7%
Louisiana572747.4%
Maine54<11not reported
Nevada453066.7%
Tennessee43<11not reported
Kentucky352160.0%
Virginia341235.3%
Indiana31<11not reported
Maryland281553.6%
Wyoming281139.3%
Alabama27<11not reported
Minnesota23<11not reported
Michigan23<11not reported
Oklahoma21<11not reported
North Carolina19<11not reported
Alaska18<11not reported
South Carolina15<11not reported
New Mexico15<11not reported
Wisconsin15<11not reported
West Virginia14<11not reported
Massachusetts12<11not reported
Iowa12<11not reported
Montana11<11not reported
Kansas11<11not reported

New NPI registrations by year

Year first enumeratedNPIs
2016136
2017140
2018120
2019112
202098
202186
202268
202388
2024108
2025162

Counts reflect the year each NPI was first issued, among records still active today. The final year is partial: this data covers through 2026-01-11.

Data notes

Source: CMS National Plan and Provider Enumeration System (NPPES) Data Dissemination file, FOIA-disclosable public data under CMS-6060-N. Aggregated by Hero EMR on 2026-08-03; deactivated NPIs excluded; specialty assigned from the primary taxonomy code (NUCC 25.1). Counts below 11 are suppressed. Individual providers are never published. All provider data pages.

Common questions

How many Registered Nurse First Assistants are there in the US?

The dataset includes 3,096 active NPI records with Registered Nurse First Assistant as the primary taxonomy.

How many Registered Nurse First Assistants are in private practice?

NPPES flags 1,398 records, or 45.2%, as sole proprietors. This is an imperfect proxy for private practice because the field is self-reported and does not fully describe practice arrangements.

Which states have the most Registered Nurse First Assistants?

The largest state counts are in Texas (445), California (317), New Jersey (276), Florida (271), and Georgia (138).

Does the NPI total equal the number of RNFAs working in the US?

No. It counts active NPI records whose primary taxonomy is Registered Nurse First Assistant, not a direct census of people, jobs, or clinical activity.

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