Individual provider Active NPI

Caitlin Hickok, RN, FNP-C

  • Nurse Practitioner
  • Ronan, MT
National Provider Identifier
1174988828
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
160707 Issued in MT
Practice address
126 6TH Ave SW
Ronan, MT 59864-2600
Phone
(406) 676-3600
Fax
(406) 676-3738
NPI assigned
Dec 23, 2015
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN250202 GA
Nurse Practitioner 363L00000X 160707 MT Primary
Registered Nurse 163W00000X RN250202 GA

Addresses

Primary practice location

126 6TH Ave SW
Ronan, MT 59864-2600

Mailing address

2819 Great Northern Loop
Missoula, MT 59808-1750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20250829003662 MT Practitioner - Nurse Practitioner 6103327234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Community HospitalGroup PAC ID 5496659567, shared by 8 NPIs, 59 clinicians

Practice addresses (Care Compare)

104 Rufus LN
Polson, MT 59860-8903
Phone (406) 883-2555

107 Ridgewater Dr
Polson, MT 59860-8977
Phone (406) 883-3737

126 6TH Ave SW
Ronan, MT 59864-2600
Phone (406) 676-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN250202GAMDNurse Practitioner
160707MTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lukes Community Hospital Current Accepting new patients
St Lukes Community Hospital CurrentSince Aug 1, 2025 Accepting new patients
St Lukes Community Hospital CurrentSince Dec 1, 2025 Accepting new patients
St Lukes Community Hospital CurrentSince Aug 1, 2025 Accepting new patients
North Chattahoochee Family Physicians, LLC PastSince Aug 1, 2019 Accepting new patients
St. Lukes Community Hospital Past Accepting new patients
Forsyth County Board of Health Past Accepting new patients
Costcare, PLLC PastSince Aug 27, 2023 Accepting new patients
Forsyth County Health Department Past Accepting new patients

Locations

107 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

126 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

126 6th Ave SW
Ste B
Ronan, MT 59864
Phone (406) 676-4436

Interoperability endpoints

  • Direct secure messaging: caitlin.hickok@165427463913476.direct.elationemr.com

Organizations & group practices 9

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 1

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1174988828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 GREAT NORTHERN LOOP",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 6TH AVE SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642600",
            "telephone_number": "406-676-3600",
            "fax_number": "406-676-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKOK",
        "first_name": "CAITLIN",
        "credential": "RN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN250202",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "160707",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN250202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronan, MT

Sources for this page

Verify at the official NPI Registry.