Active NPI
Kenzie K Vickers
- Student in an Organized Health Care Education/Training Program
- Terre Haute, IN
National Provider Identifier
1669217378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1433 N 6TH 1/2 St
Terre Haute, IN 47807-1037 - Phone
- (812) 237-7609
- NPI assigned
- Jun 26, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1433 N 6TH 1/2 St
Terre Haute, IN 47807-1037
Mailing address
1433 N 6TH 1/2 St
Terre Haute, IN 47807-1037
Phone (812) 237-7609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250618002833 | IN | Order and Referring Only - Family Practice | 7517478258 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733875200000",
"number": "1669217378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1433 N 6TH 1/2 ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478071037",
"telephone_number": "812-237-7609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 N 6TH 1/2 ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478071037",
"telephone_number": "812-237-7609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "KENZIE",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-26",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.