Randy Scott Hicks, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CA-PT29992 Issued in CA

Practice address

7405 N Cedar Ave
103
Fresno, CA 93720-3838

Phone

(559) 261-4100

Fax

(559) 261-4101

NPI assigned

Oct 10, 2006

Last updated

May 27, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Sports and Orthopedic Physical Therapy Clinic IncGroup PAC ID 9436314200, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sports & Orthopedic Physical Therapy Clinic Inc

  • Physical Therapy Clinic/Center
  • Fresno, CA
  • NPI 1922186956

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Optimal Rehab Physical Therapy Inc.

  dba Optimal Rehab Physical Therapy

  • Orthopedic Physical Therapist
  • Fresno, CA
  • NPI 1942211669
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1013005990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 N CEDAR AVE",
            "address_2": "103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203838",
            "telephone_number": "559-261-4100",
            "fax_number": "559-261-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 N CEDAR AVE",
            "address_2": "103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203838",
            "telephone_number": "559-261-4100",
            "fax_number": "559-261-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "RANDY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "CA-PT29992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP #",
            "identifier": "DA6172",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD IND. #",
            "identifier": "P00459387",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0PT299920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Hicks
• Kyle Douglas Hicks
• Linda May Hicks, RN
• Loretta Charlene Hicks, RN/MSN/PNP/FNP
• Neshondra Hicks
• Taylor Mae Hicks
• Vilma Hidalgo
• Kelline Lynn Hiday, PSY.D., LPC, RPT
• Tamara Tangee Hiebert
• Hien Ngoc Pham DDS Inc (Family Dental Care)

• Physical Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.