Individual provider Active NPI

Jessica Hickman

  • Psychiatric/Mental Health Nurse Practitioner
  • Rosenberg, TX
National Provider Identifier
1396235289
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP137444 Issued in TX
Practice address
4910 Airport Ave Ste a
Rosenberg, TX 77471-5759
Phone
(281) 239-1300
Fax
(281) 239-0828
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 779781 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP137444 TX Primary

Addresses

Primary practice location

4910 Airport Ave Ste a
Rosenberg, TX 77471-5759

Mailing address

4910 Airport Ave Ste D
Rosenberg, TX 77471-5759
Phone (281) 239-1445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180606003067 TX Practitioner - Nurse Practitioner 7012272313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texana CenterGroup PAC ID 7618963265, 23 clinicians

Practice addresses (Care Compare)

4910 Airport Ave
Suite D
Rosenberg, TX 77471-5759
Phone (281) 239-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
779781TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texana Center CurrentSince Jul 27, 2020 Accepting new patients
Aslam Loya, M.D. P.a Past Accepting new patients
Texana Center Past Accepting new patients

Locations

400 Avenue F
Bay City, TX 77414
Phone (979) 245-9231

539 FM 359 Rd S
Brookshire, TX 77423

1460 Walnut St
Columbus, TX 78934
Phone (979) 732-6204

4910 Airport Ave
Ste A
Rosenberg, TX 77471
Phone (281) 239-1300

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

2535 Cordes Dr
Sugar Land, TX 77479
Phone (281) 276-4400

3007 N Richmond Rd
Wharton, TX 77488
Phone (409) 732-2356

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1396235289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 AIRPORT AVE STE D",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715759",
            "telephone_number": "281-239-1445",
            "fax_number": "281-239-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 AIRPORT AVE STE A",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715759",
            "telephone_number": "281-239-1300",
            "fax_number": "281-239-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "779781",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP137444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

Verify at the official NPI Registry.