Michelle Rae Hicks, ICADC, CADC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1151 S 4TH St Ste 208
Louisville, KY 40203-3101

Phone

(502) 612-6981

NPI assigned

Dec 20, 2019

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Louisville Integrated Care

  • Addiction Medicine (Family Medicine) Physician
  • Louisville, KY
  • NPI 1669093647
  NPD Authorized official

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1154969129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 LOCKLEE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402143831",
            "telephone_number": "502-612-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 S 4TH ST STE 208",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033101",
            "telephone_number": "502-612-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MICHELLE",
        "middle_name": "RAE",
        "credential": "ICADC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrhicks@ualr.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1151 S 4th St Ste 208",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrhicks@ualr.edu",
            "affiliation": "N",
            "endpointDescription": "email contact information",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1151 S 4th St Ste 208",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402033101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Connor Hicks
• David Lawrence Hicks, MD
• Kaitlyn Hicks, FNP-C
• Madeline M Hicks, DMD
• Matthew Hicks, M.D.
• Ronald Tyrone Hicks Sr., RADPSS
• Scott Glen Hicks, APRN
• Thanh Lien Hicks, DPT
• Wallace Kent Hicks, ED.D.
• Lindsey Hickson, AUD

• Case Manager/Care Coordinator in Louisville, KY
• Providers in Louisville, KY by specialty
• Case Manager/Care Coordinator in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.