Individual provider Active NPI

Nicole Denise Hickson, NP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1073157459
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R204896 Issued in MD
Practice address
1120 N Charles St Ste 400
Baltimore, MD 21201-5594
Phone
(443) 739-3814
Fax
(833) 975-0904
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R204896 MD Primary

Addresses

Primary practice location

1120 N Charles St Ste 400
Baltimore, MD 21201-5594

Mailing address

1120 N Charles St Ste 400
Baltimore, MD 21201-5594
Phone (443) 739-3889

Other identifiers 1

IdentifierTypeStateIssuer
666351600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210205001139 MD Practitioner - Nurse Practitioner 5991119794 Reassigns benefits to 1 organization
I20220330000174 DC Practitioner - Nurse Practitioner 5991119794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1120 N Charles St
Suite 400
Baltimore, MD 21201-5594
Phone (443) 760-0564

Hospital & facility affiliations

  • Homecentris Home Health II Home health agency, Owings Mills, MD, CCN 217058
  • Home Call, Inc Home health agency, Westminster, MD, CCN 217115
  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Homecall Home health agency, Baltimore, MD, CCN 217123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R204896MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Access P.C. CurrentSince Feb 1, 2022 Accepting new patients
Pathway to Wellness Healthcare Center Family CurrentSince Jan 1, 2021 Accepting new patients
Manbir Takhar, P.C. CurrentSince Feb 1, 2022 Accepting new patients
Tru Health Group, PC Current Accepting new patients

Locations

1120 N Charles St
Ste 400
Baltimore, MD 21201
Phone (443) 271-9907

11000 Baltimore Ave
Ste 104
Beltsville, MD 20705

12321 Middlebrook Rd
Ste 102
Germantown, MD 20874
Phone (301) 428-3192

12321 Middlebrook Rd
Ste 101
Germantown, MD 20874
Phone 3014281070260

12321 Middlebrook Rd
Germantown, MD 20874
Phone (301) 741-3814

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22883/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nicole.hickson.1@22883.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1073157459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N CHARLES ST STE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015594",
            "telephone_number": "443-739-3889",
            "fax_number": "833-975-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N CHARLES ST STE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015594",
            "telephone_number": "443-739-3814",
            "fax_number": "833-975-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKSON",
        "first_name": "NICOLE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R204896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "666351600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.