Individual provider Active NPI

Kassy Layne Hickman, AUDIOLOGIST

  • Audiologist
  • Fredericksburg, VA
National Provider Identifier
1063258150
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2205000007 Issued in VA
Practice address
1708 Fall Hill Ave Ste 200
Fredericksburg, VA 22401-3511
Phone
(540) 371-1263
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2205000007 VA Primary

Addresses

Primary practice location

1708 Fall Hill Ave Ste 200
Fredericksburg, VA 22401-3511

Mailing address

1708 Fall Hill Ave Ste 200
Fredericksburg, VA 22401-3511
Phone (540) 371-1263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240805001416 VA Practitioner - Qualified Audiologist 0749727030 Reassigns benefits to 1 organization
I20250221002815 WV Practitioner - Qualified Audiologist 0749727030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Ohio Medical University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

1065 Suncrest Town Centre Dr
Morgantown, WV 26505-1875
Phone (304) 599-3959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2205000007VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Resource Center LLC Audiologist CurrentSince Jul 21, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Mar 10, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Mar 10, 2025 Accepting new patients
Ear Nose and Throat and Facial Plastic Surgery Center of Frederick CurrentSince Jun 25, 2024 Accepting new patients

Locations

10 Highland Park Dr
Uniontown, PA 15401
Phone (724) 439-1060

1708 Fall Hill Ave
Ste 100
Fredericksburg, VA 22401
Phone (540) 371-1226

1708 Fall Hill Ave
Ste 200
Fredericksburg, VA 22401
Phone (540) 371-1226

1065 Suncrest Town Centre Dr
Morgantown, WV 26505
Phone (304) 599-3959

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1063258150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 FALL HILL AVE STE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013511",
            "telephone_number": "540-371-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 FALL HILL AVE STE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013511",
            "telephone_number": "540-371-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "KASSY",
        "middle_name": "LAYNE",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2205000007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.