Active NPI
Kelsie Hicks
- Physical Therapist
- Ashland, KY
National Provider Identifier
1639795362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007959
- Practice address
- 2400 13TH St
Ashland, KY 41102-4510 - Phone
- (606) 329-0910
- Fax
- (606) 325-8434
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007959 | KY | Primary |
Addresses
Primary practice location
2400 13TH St
Ashland, KY 41102-4510
Mailing address
PO Box 1240
Ashland, KY 41105-1240
Phone (606) 325-7955
Other practice location 1
1490 Diederich Blvd
Russell, KY 41169-1719
Phone (606) 833-9444
Other practice location 2
710 N Carol Malone Blvd Ste A
Grayson, KY 41143-1126
Phone (606) 474-0157
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004274 | Other | WV | PHYSICAL THERAPIST LICENSE |
| 007959 | Other | KY | PHYSICAL THERAPIST LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007959 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1639795362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1240",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411051240",
"telephone_number": "606-325-7955",
"fax_number": "606-325-9848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 13TH ST",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411024510",
"telephone_number": "606-329-0910",
"fax_number": "606-325-8434"
}
],
"practiceLocations": [
{
"address_1": "1490 Diederich Blvd",
"address_purpose": "LOCATION",
"city": "Russell",
"state": "KY",
"postal_code": "411691719",
"country_code": "US",
"telephone_number": "606-833-9444",
"fax_number": "606-833-9442",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "710 N Carol Malone Blvd Ste A",
"address_purpose": "LOCATION",
"city": "Grayson",
"state": "KY",
"postal_code": "411431126",
"country_code": "US",
"telephone_number": "606-474-0157",
"fax_number": "606-474-0890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKS",
"first_name": "KELSIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-18",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "KY",
"license": "007959",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST LICENSE",
"identifier": "004274",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST LICENSE",
"identifier": "007959",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.