Individual provider Active NPI

Anna Hicks

  • Occupational Therapist
  • Ridgeland, MS
National Provider Identifier
1255947644
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3677 Issued in MS
Practice address
950 E County Line Rd Ste a
Ridgeland, MS 39157-1928
Phone
(601) 308-5117
Fax
(601) 308-5103
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3677 MS Primary

Addresses

Primary practice location

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928

Mailing address

PO Box 720610
Byram, MS 39272-0610
Phone (601) 308-5117

Other names 1

  • Anna Herrington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725001552 MS Practitioner - Occupational Therapist in Private Practice 8820459738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab Agency Ms LLCGroup PAC ID 2769841782, 66 clinicians

Practice addresses (Care Compare)

205 Industrial CV
Ridgeland, MS 39157-2715
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3677MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Agency Ms LLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients
Performance Rehab, Inc PastSince Sep 27, 2020 Accepting new patients

Locations

74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1255947644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720610",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392720610",
            "telephone_number": "601-308-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-308-5117",
            "fax_number": "601-308-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "HERRINGTON",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2021; 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.