Individual provider Active NPI

Kristiana Hickenbotham, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Terre Haute, IN
National Provider Identifier
1386511707
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71017270A Issued in IN
Practice address
620 8TH Ave
Terre Haute, IN 47804-2771
Phone
(812) 231-8242
Fax
(812) 954-0141
NPI assigned
Oct 21, 2025
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71017270A IN Primary

Addresses

Primary practice location

620 8TH Ave
Terre Haute, IN 47804-2771

Mailing address

620 8TH Ave
Terre Haute, IN 47804-2771
Phone (812) 231-8242

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251202001084 IN Practitioner - Nurse Practitioner 4688167364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hamilton Center, Inc.Group PAC ID 4284533662, 42 clinicians

Practice addresses (Care Compare)

620 8TH Ave
Terre Haute, IN 47804-2744
Phone (812) 231-8323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71017270AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Center, Inc. CurrentSince Oct 14, 2025 Accepting new patients
Hamilton Center Inc. CurrentSince Oct 14, 2025 Accepting new patients

Locations

620 8th Ave
Terre Haute, IN 47804
Phone (812) 231-8200

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

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1386511707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042771",
            "telephone_number": "812-231-8242",
            "fax_number": "812-954-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042771",
            "telephone_number": "812-231-8242",
            "fax_number": "812-954-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKENBOTHAM",
        "first_name": "KRISTIANA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71017270A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.