Individual provider Active NPI

Jessica R Hicks, CNA

  • Nurse's Aide
  • Jacksonville, FL
National Provider Identifier
1063380012
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
NA.00807495 Issued in CO
Practice address
7643 Gate Pkwy Ste 104-996
Jacksonville, FL 32256-3092
Phone
(904) 599-3087
NPI assigned
Oct 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NA.00807495 CO Primary

Addresses

Primary practice location

7643 Gate Pkwy Ste 104-996
Jacksonville, FL 32256-3092

Mailing address

7643 Gate Pkwy Ste 104-996
Jacksonville, FL 32256-3092
Phone (904) 599-3087

Other practice location 1

18315 Cottonwood Dr
Parker, CO 80138-8903
Phone (904) 599-3087

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
NA.00807495COMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1063380012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-996",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563092",
            "telephone_number": "904-599-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-996",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563092",
            "telephone_number": "904-599-3087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18315 Cottonwood Dr",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801388903",
            "country_code": "US",
            "telephone_number": "904-599-3087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JESSICA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CO",
            "license": "NA.00807495",
            "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 Oct 29, 2025; 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.