Quintara Hicks, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26845 Issued in SC

Practice address

115 Atrium Way BLDG Ste 221
Columbia, SC 29223-6371

Phone

(803) 699-8887

NPI assigned

May 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapeutic Wellness LLCGroup PAC ID 1658817739, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Therapeutic Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lancaster, SC
  • NPI 1144060476
  Medicare reassignment Care Compare group NPD Authorized official
• Graceful Journey Home Health of SC LLC

  • Home Health Agency
  • Rock Hill, SC
  • NPI 1073479267
  NPD Authorized official
• Graceful Journey Hospice LLC

  • Community Based Hospice Care Agency
  • Rock Hill, SC
  • NPI 1851113898
  NPD Authorized official
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1205572260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 FOX TRL",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245926147",
            "telephone_number": "804-370-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY BLDG STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236371",
            "telephone_number": "803-699-8887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1133 Fox Trl",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245926147",
            "country_code": "US",
            "telephone_number": "804-370-3783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "QUINTARA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0001278937",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "26845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Hicks
• Leigh Hicks
• Maleah Alta Jadelle Hicks
• Megan Hicks
• Patricia W Hicks, R.N.
• Ronald Jeffery Hicks
• Shannon Miller Hicks, DPT
• Hidden Talents ABA SC
• Vanessa Galvarino Hiers, MSW, LMSW
• Deborah Higgins, APRN

• Psychiatric/Mental Health Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.