Susan Jane Nisson Hicks, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R091864 Issued in MD

Practice address

3145 Marshall Hall Rd
Bryans Road, MD 20616-4263

Phone

(301) 609-5350

Fax

(301) 684-2134

NPI assigned

Jun 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Jane Nisson Hicks Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment Care Compare group NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1164049029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210902924",
            "telephone_number": "301-609-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 MARSHALL HALL RD",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206164263",
            "telephone_number": "301-609-5350",
            "fax_number": "301-684-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSON HICKS",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R091864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HICKS",
            "middle_name": "JANE NISSON",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Briody Anne Martin, PHARMD
• Maryland CVS Pharmacy, L.L.C.
• Solomon A Melson, LCSW
• Chakayla Middleton
• Niki 2 LLC
• Canisia Defang Njinkeng
• Chiamaka Nwokeji, PHARMD
• Lori Michelle Paylor, PHARM D
• Prince George'S County Health
• Jennifer Christine Rhodes, RN

• Family Nurse Practitioner in Bryans Road, MD
• Providers in Bryans Road, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.