Riley Jo Hicks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

24 Physicians Dr
Jackson, TN 38305-2070

Phone

(731) 592-4255

NPI assigned

Jun 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Riley Jo Tate Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Tennessee Bone and Joint Clinic PCGroup PAC ID 7517940182, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072
• Henderson County Community Hospital Hospital, Lexington, TN, CCN 440008
• West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: riley.hicks.1@3533.direct.athenahealth.com

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.

• West Tennessee Bone and Joint Clinic PC

  • Specialist
  • Jackson, TN
  • NPI 1831312461
  Medicare reassignment Care Compare group

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

• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• Lexington Hospital Corporation

  dba Henderson County Community Hospital

  • General Acute Care Hospital
  • Lexington, TN
  • NPI 1255302923
  Care Compare affiliation
• Milan General Hospital, Inc.

  dba West Tennessee Healthcare Milan Hospital

  • General Acute Care Hospital
  • Milan, TN
  • NPI 1699765453
  Care Compare affiliation

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1639910243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-592-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-592-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "RILEY",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RILEY",
            "last_name": "TATE",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aishia E Hibbler, M.S.
• James Clinton Hickerson, CASE MANAGER
• Megan Hickerson, FNP
• Michelle Dawn Hickerson, APN
• Miranda Sue Hicks, NP-C
• Kpienoba Manan Hien, M.D
• Richmond A Higginbotham, CRNA
• Andrea Higgins, CASE MANAGER
• Bobby Clark Higgs, MD
• Evette L Higgs, CRISIS CLINICIAN

• Physician Assistant in Jackson, TN
• Providers in Jackson, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.