Individual provider Active NPI

Vanessa Hinckson, M.D.

  • Pediatrics Physician
  • Malabar, FL
National Provider Identifier
1467735225
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME113712 Issued in FL
Practice address
775 Malabar Rd
Malabar, FL 32950-3120
Phone
(321) 722-8435
Fax
(321) 722-8486
NPI assigned
Sep 27, 2011
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X ME113712 FL Primary

Addresses

Primary practice location

775 Malabar Rd
Malabar, FL 32950-3120

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140512001893 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0547493892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vanessa.hinckson@bha.eclinicaldirectplus.com

Organizations & group practices 1

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1467735225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 MALABAR RD",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "329503120",
            "telephone_number": "321-722-8435",
            "fax_number": "321-722-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINCKSON",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME113712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malabar, FL

Sources for this page

Verify at the official NPI Registry.