Vanessa Gammill Lickson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11000074 Issued in FL

Practice address

16875 NE Cayson St
Blountstown, FL 32424-2209

Phone

(850) 674-2244

Fax

(850) 674-2249

NPI assigned

Oct 27, 2018

Reactivated

Jan 8, 2019

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vanessalickson@cdrhci.allscriptsdirect.net

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.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment Care Compare group NPD
• CDR Health Care Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1497352587
  Medicare reassignment NPD
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Blountstown, FL
  • NPI 1316759244
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMH Physician Partners

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMHPP Anesthesiology PCB

  • Anesthesiology Physician
  • Panama City Beach, FL
  • NPI 1992532477
  NPD
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, FL
  • NPI 1275346108
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Care Compare affiliation

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

{
    "created_epoch": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1609343698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013409",
            "telephone_number": "850-747-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16875 NE CAYSON ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242209",
            "telephone_number": "850-674-2244",
            "fax_number": "850-674-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKSON",
        "first_name": "VANESSA",
        "middle_name": "GAMMILL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-27",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "deactivation_date": "2018-11-14",
        "reactivation_date": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11000074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000074",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9301316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Spencer Layne, DDS
• Chesnee Layne
• Raymond H Layne Jr., DDS
• Courtney Rebecca Lewis, COTA
• Kristen C Lewis
• Life Management Center of Northwest Florida Inc
• Cindy Lollie
• Ian Grant Lott, DPT
• Pamela Diane Mash, COUNSELOR
• McClellan Chiropractic Center PA

• Family Nurse Practitioner in Blountstown, FL
• Providers in Blountstown, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.

Verify at the official NPI Registry.