Kaitlyn Marie Hickman

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P22037 Issued in NC

Practice address

1163 7 Lakes Dr
West End, NC 27376

Phone

(910) 673-5437

Fax

(910) 673-5438

NPI assigned

Mar 3, 2023

Last updated

Mar 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moore Pediatric Therapy Serivces

  • Community/Behavioral Health Agency
  • West End, NC
  • NPI 1356701528
  NPD (past)
• Moore Pediatric Therapy Serivces

  • Specialist
  • West End, NC
  • NPI 1982864849
  NPD (past)

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1629778238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 354",
            "city": "WEST END",
            "state": "NC",
            "postal_code": "273760354",
            "telephone_number": "910-673-5437",
            "fax_number": "910-673-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 7 LAKES DR",
            "city": "WEST END",
            "state": "NC",
            "postal_code": "27376",
            "telephone_number": "910-673-5437",
            "fax_number": "910-673-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "P22037",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfonso Haro, DPM
• Jennifer Harvey, FNP, PMHNP
• Haven Total Wellness, PLLC
• Hearing Solutions of the Sandhills
• Halie Herrin, MA
• Amanda Yarbrough Hill, M.ED., CCC-SLP
• Kristin Yearby Hockersmith, FNP
• Joanne F. Horak, SAC
• Independent Assessment Consultants, LTD. (Ronald D. Franklin, PhD, ABPdN)
• Alisha Janis, M.S.W.

• Physical Therapist in West End, NC
• Providers in West End, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.