Active NPI
Rebecca Hickman, PA
- Medical Physician Assistant
- Centennial, CO
National Provider Identifier
1538466990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4049
- Practice address
- 5555 E Arapahoe Rd
Centennial, CO 80122-2312 - Phone
- (303) 338-4545
- NPI assigned
- Feb 22, 2011
- Last updated
- Jul 8, 2015
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 4049 | CO | Primary |
| Medical Physician Assistant | 363AM0700X | 085003849 | IL |
Addresses
Primary practice location
5555 E Arapahoe Rd
Centennial, CO 80122-2312
Mailing address
5555 E Arapahoe Rd
Centennial, CO 80122-2312
Phone (303) 338-4545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19356269 | Medicaid | CO | |
| 025233 | Other | CO | KAISER COMMERCIAL NUMBER |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4049 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Brown Health Center | Past | Accepting new patients | |
| Howard Brown Health Center | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1306048632
-
- Health Educator
- Chicago, IL
- NPI 1811824121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1538466990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 E ARAPAHOE RD",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801222312",
"telephone_number": "303-338-4545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 E ARAPAHOE RD",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801222312",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "REBECCA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-22",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "4049",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085003849",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "19356269",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "025233",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.