Individual provider Active NPI

Tameshia I Hicks

  • Prosthetics Case Management
  • Jacksonville, FL
National Provider Identifier
1003406067
Registry record updated Jan 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
CL1185672 Issued in FL
Practice address
8036 Philips Hwy Ste 4
Jacksonville, FL 32256-7466
Phone
(904) 233-5471
NPI assigned
Jan 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X CL1185672 FL Primary

Addresses

Primary practice location

8036 Philips Hwy Ste 4
Jacksonville, FL 32256-7466

Mailing address

1743 Cavalcade CT
Jacksonville, FL 32218-6227
Phone (904) 233-5471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CL1185672FLMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1611446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611446400000",
    "number": "1003406067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 CAVALCADE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186227",
            "telephone_number": "904-233-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8036 PHILIPS HWY STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567466",
            "telephone_number": "904-233-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "TAMESHIA",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-24",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "FL",
            "license": "CL1185672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.