Shayla Mae Kicklighter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15826 Issued in TX

Practice address

12222 N Central Expy Ste 420
Dallas, TX 75243-3825

Phone

(972) 985-2797

Fax

(972) 985-4797

NPI assigned

Jun 30, 2021

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shayla.kicklighter@hca7.eclinicaldirectplus.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.

• Prisma Health Medical Group-Midlands

  dba PH Dentistry

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, SC
  • NPI 1417442864

  Multi-Specialty

  NPD
• Prisma Health Medical Group-Midlands

  dba PH Dentistry

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1083284004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12222 N CENTRAL EXPY STE 420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433825",
            "telephone_number": "972-985-2797",
            "fax_number": "972-985-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 N CENTRAL EXPY STE 420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433825",
            "telephone_number": "972-985-2797",
            "fax_number": "972-985-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLIGHTER",
        "first_name": "SHAYLA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julius Njure Kibe, NP
• Esther Okaya Kibira, NP-C
• Eric J Kibodeaux, DC
• Kara Janette Kichler, MD
• Dwayne Kicklighter, PT
• Kid Pro, PLLC
• Buruk Kidane
• Dawit Kidane
• Ezana Kidane
• Milla Kidane

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.