Polly Anne Hickman, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP-01858 Issued in NM

Practice address

2669 Scenic Dr
Alamogordo, NM 88310-8700

Phone

(575) 446-5300

Fax

(575) 446-5304

NPI assigned

Nov 23, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: polly.ann.hickman.1@6965.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579

  NM

  Medicare reassignment Care Compare group NPD
• Otero County Hospital Association

  • Community/Retail Pharmacy
  • Alamogordo, NM
  • NPI 1235948803
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1013284777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108700",
            "telephone_number": "575-446-5300",
            "fax_number": "575-446-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108700",
            "telephone_number": "575-446-5300",
            "fax_number": "575-446-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "POLLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP-01858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Alamogordo, NM
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.