Active NPI
Kaitlyn Amber Hicks, MT-BC
- Music Therapist
- Rochester, MN
National Provider Identifier
1336962927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 19072
- Practice address
- 847 Civic Center Dr NW
Rochester, MN 55901 - Phone
- (507) 236-7793
- NPI assigned
- Nov 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 19072 | WI | Primary |
Addresses
Primary practice location
847 Civic Center Dr NW
Rochester, MN 55901
Mailing address
4105 46TH Ave NW Apt 317
Rochester, MN 55901-8557
Phone (763) 607-2348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19072 | WI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1336962927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 46TH AVE NW APT 317",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559018557",
"telephone_number": "763-607-2348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "847 CIVIC CENTER DR NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "507-236-7793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "KAITLYN",
"middle_name": "AMBER",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "WI",
"license": "19072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.