Individual provider Active NPI

Alisha Lickwar, WHNP-BC, MSN, RN

  • Women's Health Nurse Practitioner
  • Warren, OH
National Provider Identifier
1154057297
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0031856 Issued in OH
Practice address
200 Garfield Dr NE Ste 1
Warren, OH 44483-5557
Phone
(330) 372-1828
NPI assigned
Jul 30, 2022
Last updated
Jul 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0031856 OH Primary

Addresses

Primary practice location

200 Garfield Dr NE Ste 1
Warren, OH 44483-5557

Mailing address

2230 Salt Springs Rd
Warren, OH 44481-9766
Phone (330) 394-4597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220912003450 OH Practitioner - Nurse Practitioner 7719362755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 E Market St
Warren, OH 44483-6625
Phone (330) 399-5577

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0031856OHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Oct 3, 2022 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Oct 3, 2022 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
Cortland OBGYN Associates Inc PastSince Aug 7, 2022 Accepting new patients

Locations

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

1700 E Market St
Warren, OH 44483
Phone (330) 393-8888

Interoperability endpoints

  • Direct secure messaging: alickwar20451@nomshealthcare.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1154057297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 SALT SPRINGS RD",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444819766",
            "telephone_number": "330-394-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GARFIELD DR NE STE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444835557",
            "telephone_number": "330-372-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKWAR",
        "first_name": "ALISHA",
        "credential": "WHNP-BC, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "0031856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.