Individual provider Active NPI

Kelli Elizabeth Hicks, DNP

  • Family Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1114573110
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2267675 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-5083
Phone
(781) 744-8000
NPI assigned
Aug 15, 2019
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2267675 MA Primary
Nurse Practitioner 363L00000X RN2267675 MA
Registered Nurse 163W00000X RN66560 RI
Family Nurse Practitioner 363LF0000X CAPRN02386 RI

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-5083

Mailing address

PO Box 24520
New York, NY 10087-3720

Other practice location 1

176 Toll Gate Rd Ste 103
Warwick, RI 02886-4479
Phone (401) 921-5855

Other practice location 2

1351 S County Trl Ste 301
East Greenwich, RI 02818-5083
Phone (401) 398-0860

Other names 1

  • Kelli Elizabeth McLoughlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 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
I20200422000968 MA Practitioner - Nurse Practitioner 4880024447 Reassigns benefits to 3 organizations
I20200929002069 RI Practitioner - Nurse Practitioner 4880024447

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1350 Market St
Lynnfield, MA 01940-4048
Phone (781) 213-4050

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

PO Box
Melrose, FL 32666-1099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN66560RIMDRegistered Nurse
CAPRN02386RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Apr 30, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Lahey Clinic, Inc. CurrentSince Apr 30, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#1500
Boston, MA 02114
Phone (617) 724-3842

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1114573110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018055083",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Toll Gate Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864479",
            "country_code": "US",
            "telephone_number": "401-921-5855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1351 S County Trl Ste 301",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028185083",
            "country_code": "US",
            "telephone_number": "401-398-0860",
            "fax_number": "401-398-0861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KELLI",
        "middle_name": "ELIZABETH",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2267675",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2267675",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN66560",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "CAPRN02386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "MCLOUGHLIN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.