Individual provider Active NPI

Jordan P Hicks, P.T.

  • Physical Therapist
  • Nashville, TN
National Provider Identifier
1356639199
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9092 Issued in TN
Practice address
4230 Harding Pike Ste 400
Nashville, TN 37205-4900
Phone
(615) 921-6504
Fax
(615) 921-6505
NPI assigned
Jul 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9092 TN Primary

Addresses

Primary practice location

4230 Harding Pike Ste 400
Nashville, TN 37205-4900

Mailing address

800 Crescent Centre Dr Ste 600
Franklin, TN 37067-7286
Phone (615) 373-1350

Other practice location 1

156 N Belvedere Dr
Gallatin, TN 37066-5418
Phone (615) 451-1877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260505003766 OR Practitioner - Physical Therapist in Private Practice 9537337464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

4876 NW Bethany Blvd
Suite L1
Portland, OR 97229-9259
Phone (503) 466-2254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews & Gant Therapy, LLC Past Accepting new patients
Agilitas USA Inc Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1356639199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 600",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677286",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372054900",
            "telephone_number": "615-921-6504",
            "fax_number": "615-921-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 N Belvedere Dr",
            "address_purpose": "LOCATION",
            "city": "Gallatin",
            "state": "TN",
            "postal_code": "370665418",
            "country_code": "US",
            "telephone_number": "615-451-1877",
            "fax_number": "615-451-1878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JORDAN",
        "middle_name": "P",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.