Active NPI
Mary Hicks, NP
- Adult Health Nurse Practitioner
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 4704154971
- Practice address
- 1 Ford PL
Detroit, MI 48202 - Phone
- (800) 653-6568
- NPI assigned
- Nov 2, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704154971 | MI | Primary |
| Nurse Practitioner | 363L00000X | 4704154971 | MI |
Addresses
Primary practice location
1 Ford PL
Detroit, MI 48202
Mailing address
28690 Old North River Rd
Harrison TWP, MI 48045-1619
Phone (586) 801-8488
Other practice location 1
22151 Moross Rd
PBI Suite 131
Detroit, MI 48236-2167
Phone (313) 343-3072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447241229 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Macomb Hospital Corporation | Nurse Practitioner | Current | Accepting new patients |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Nurse Practitioner | Current | Accepting new patients |
Locations
30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000
15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300
15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
1 Ford Pl
Detroit, MI 48202
Phone (313) 874-4118
Interoperability endpoints
- mhicks296433@direct.hfhs.org
Organizations & group practices 4
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.
-
dba Henry Ford Macomb Health Center Chesterfield
- Nurse Practitioner
- Chesterfield, MI
- NPI 1952440521
-
- Nurse Practitioner
- Detroit, MI
- NPI 1104900455
-
dba Henry Ford Health Macomb Hospital
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- Neonatal Nurse Practitioner
- Clinton Township, MI
- NPI 1912301094
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Henry Ford Health Macomb Hospital
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- General Acute Care Hospital
- Warren, MI
- NPI 1902842735
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1447241229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28690 OLD NORTH RIVER RD",
"city": "HARRISON TWP",
"state": "MI",
"postal_code": "480451619",
"telephone_number": "586-801-8488",
"fax_number": "586-228-4520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 FORD PL",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "800-653-6568"
}
],
"practiceLocations": [
{
"address_1": "22151 Moross Rd",
"address_2": "PBI Suite 131",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482362167",
"country_code": "US",
"telephone_number": "313-343-3072",
"fax_number": "313-343-4234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKS",
"first_name": "MARY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-02",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704154971",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704154971",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447241229",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.