Individual provider Active NPI

Cheryl Lynn Nicks, NNP

  • Neonatal Nurse Practitioner
  • Marrero, LA
National Provider Identifier
1174714588
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP01190 Issued in LA
Practice address
1101 Medical Ctr. Blvd.
Nicu
Marrero, LA 70072
Phone
(504) 349-2427
Fax
(504) 349-2426
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 01190 LA
Neonatal Nurse Practitioner 363LN0000X AP01190 LA Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X RN041131 LA
Critical Care Neonatal Nurse Practitioner 363LN0005X AP01190 LA

Addresses

Primary practice location

1101 Medical Ctr. Blvd.
Nicu
Marrero, LA 70072

Mailing address

1101 Medical Ctr. Blvd.
Nicu
Marrero, LA 70072
Phone (504) 349-2427

Other identifiers 2

IdentifierTypeStateIssuer
1134007MedicaidLA
08025373MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
01190LAMDNeonatal Nurse Practitioner
AP01190LAMDCritical Care Neonatal Nurse Practitioner
RN041131LAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1174714588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CTR. BLVD.",
            "address_2": "NICU",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-2427",
            "fax_number": "504-349-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CTR. BLVD.",
            "address_2": "NICU",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-2427",
            "fax_number": "504-349-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKS",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "LA",
            "license": "01190",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "LA",
            "license": "AP01190",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "LA",
            "license": "RN041131",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "LA",
            "license": "AP01190",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134007",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08025373",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.