Active NPI
Ronnie Hicks
- Home Health Aide
- Albuquerque, NM
National Provider Identifier
1396168548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 374U0000X
- Practice address
- 9600 Central Ave SW TRLR 148
Albuquerque, NM 87121-7681 - Phone
- (562) 507-5687
- NPI assigned
- Jan 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 171M0000X | NM | |
| Occupational Therapist | 225X00000X | 225X0000X | NM | |
| Speech/Language/Hearing Specialist/Technologist | 235500000X | 23550000X | NM | |
| Home Health Aide | 374U00000X | 374U0000X | NM | Primary |
| Driver | 172A00000X |
Addresses
Primary practice location
9600 Central Ave SW TRLR 148
Albuquerque, NM 87121-7681
Mailing address
9600 Central Ave SW TRLR 148
Albuquerque, NM 87121-7681
Phone (562) 507-5687
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 |
|---|---|---|---|
| 171M0000X | NM | MD | Case Manager/Care Coordinator |
| 225X0000X | NM | MD | Occupational Therapist |
| 23550000X | NM | MD | Speech/Language/Hearing Specialist/Technologist |
| 374U0000X | NM | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1396168548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9600 CENTRAL AVE SW TRLR 148",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871217681",
"telephone_number": "562-507-5687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 CENTRAL AVE SW TRLR 148",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871217681",
"telephone_number": "562-507-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "RONNIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-23",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NM",
"license": "171M0000X",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "225X0000X",
"primary": false
},
{
"code": "235500000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist",
"state": "NM",
"license": "23550000X",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NM",
"license": "374U0000X",
"primary": true
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.