Rena Marie Hicks, L.M.T

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501004675 Issued in MI

Practice address

812 S Garfield Ave
Suite 4
Traverse City, MI 49686-3456

Phone

(231) 218-1266

NPI assigned

Oct 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rebalance Center, LLC

  • Massage Therapist
  • Traverse City, MI
  • NPI 1164967725
  NPD (past) Authorized official

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1548544646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE",
            "address_2": "SUITE 4",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-218-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE",
            "address_2": "SUITE 4",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-218-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "RENA",
        "middle_name": "MARIE",
        "credential": "L.M.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002850",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501004675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Herron
• Craig Lawrence Hexham, LPC, CCS
• Jacquelyn Jane Hexham, MSW, LLMSW, CAAC
• James Daniel Heys, M.S., BCBA, LBA
• Angela Marie Hicks
• Shannon Marie Hicks, FNP-C
• Higgins Hearing Aid Service Inc
• Phyllis Higgins
• Timothy James Higgins, B.C., H.I.S.
• Nicholas William Higgs, LLMSW

• Massage Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.