Malcolm James Lickers

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

2305202376 Issued in VA

Practice address

8191 Staples Mill Rd
Henrico, VA 23228-2751

Phone

(804) 523-2653

NPI assigned

Oct 5, 2020

Last updated

Oct 5, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.74 of 100Reported as group

Quality

80.92

Improvement activities

40

Cost

77.9

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lawrence Rehabilitation Specialists , Inc

  dba Lawrence Rehabilitation - The Gait Center

  • Rehabilitation Clinic/Center
  • Richmond, VA
  • NPI 1558444513

  Sports

  Medicare reassignment NPD

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1255938098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 QUAIL HILL DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8191 STAPLES MILL RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282751",
            "telephone_number": "804-523-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKERS",
        "first_name": "MALCOLM",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "VA",
            "license": "2305202376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine C Lewis, BCBA
• Leigh Leffingwell Lewis, FNP-C
• Sharday Lewis, OTA/L
• Sheena Lewis, RN
• Claire Han Li, MD
• Life Balance Family, LLC
• Life Journey Assisting Living LLC
• Life Matters Ministries
• Life Matters Missionary Outreach Ministries and Church
• Ronnell Markette Lightfoot

• Sports Physical Therapist in Henrico, VA
• Providers in Henrico, VA by specialty
• Sports Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.