Active NPI
Penny J. Hicks
- Physical Therapist
- Albuquerque, NM
National Provider Identifier
1649424441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2463
- Practice address
- 3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793 - Phone
- (505) 888-4469
- Fax
- (505) 889-8142
- NPI assigned
- Nov 6, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 2463 | NM | Primary |
Addresses
Primary practice location
3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793
Mailing address
3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793
Phone (505) 888-4469
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2463 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidpower Therapy Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Albuquerque, NM
- NPI 1700997863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1649424441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3530 PAN AMERICAN FWY NE STE D",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871074793",
"telephone_number": "505-888-4469",
"fax_number": "505-889-8142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 PAN AMERICAN FWY NE STE D",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871074793",
"telephone_number": "505-888-4469",
"fax_number": "505-889-8142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "PENNY",
"middle_name": "J.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-06",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "2463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.