Daniel Ray Licon Jr., NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95030499 Issued in CA

Practice address

185 E 7TH Ave
Chico, CA 95926-3356

Phone

(530) 332-4400

NPI assigned

Feb 19, 2024

Sex

Male

Sole proprietor

Yes

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 CA

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enloe Health Hospital, Chico, CA, CCN 050039
• Oroville Hospital Hospital, Oroville, CA, CCN 050030

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Enloe Medical Center

  • Urgent Care Clinic/Center
  • Chico, CA
  • NPI 1396753281
  Medicare reassignment Care Compare group NPD
• Enloe Medical Center

  • Cardiovascular Disease Physician
  • Chico, CA
  • NPI 1720099328
  NPD
• Enloe Medical Center

  • Orthopaedic Surgery Physician
  • Chico, CA
  • NPI 1770905994
  NPD
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Enloe Medical Center

  • General Acute Care Hospital
  • Chico, CA
  • NPI 1417901091
  Care Compare affiliation
• Oroville Hospital

  • General Acute Care Hospital
  • Oroville, CA
  • NPI 1871606269
  Care Compare affiliation

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1275398372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SHERIDAN AVE",
            "address_2": "48",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926",
            "telephone_number": "530-966-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E 7TH AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263356",
            "telephone_number": "530-332-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICON",
        "first_name": "DANIEL",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane L. Lewman, PSY.D.
• Brooke Leyva, LVN
• Mayra Licea Barragan, M.S. CF-SLP
• Neli Licea-Hernandez
• Ethan Lichtblau, MD
• Pallavi Lidder, LVN
• Lift Assist Inc
• Lift Assist, LLC
• Alexander J Light
• Mark W Light, MD

• Family Nurse Practitioner in Chico, CA
• Providers in Chico, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.