Individual provider Active NPI

Reanna Hickman

  • Nurse Practitioner
  • Gahanna, OH
National Provider Identifier
1245807213
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
415307 Issued in OH
Practice address
4605 Morse Rd Ste 200
Gahanna, OH 43230-7300
Phone
(614) 934-5000
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 415307 OH Primary

Addresses

Primary practice location

4605 Morse Rd Ste 200
Gahanna, OH 43230-7300

Mailing address

5592 Hensel Woods Rd
Gahanna, OH 43230-1809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241205002968 OH Practitioner - Nurse Practitioner 4284160870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
415307OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Zero, LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

5031 Forest Dr
Ste C
New Albany, OH 43054
Phone (614) 647-2526

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJGGCD

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1245807213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5592 HENSEL WOODS RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432301809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MORSE RD STE 200",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432307300",
            "telephone_number": "614-934-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "REANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "415307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.