Kerry Hicks, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R854092 Issued in MS

Practice address

7163 Goodman Rd
Olive Branch, MS 38654-1904

Phone

(662) 895-3700

Fax

(662) 895-4886

NPI assigned

Jun 30, 2006

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Anderson Physician Alliance, Inc.

  • Multi-Specialty Clinic/Center
  • Meridian, MS
  • NPI 1760798227
  NPD (past)
• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)
• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1700815263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7163 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541904",
            "telephone_number": "662-895-3700",
            "fax_number": "662-895-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7163 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541904",
            "telephone_number": "662-895-3700",
            "fax_number": "662-895-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KERRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R854092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09809597",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035971",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Henderson
• Valerian Keith Hendrix Sr., ACNP/FNP
• Henry Chiropractic Clinic PLLC
• Brian Keith Henry, D.C.
• Julie Tremor Hicks, M.D.
• Milejah Diane Higgins, PHARMD
• Heather Hildebrant, PMHNP
• Daniel Hill
• Brooke Hinds
• Connie Jean Hodge, FNP-BC, PMHNP-BC

• Family Nurse Practitioner in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.

Verify at the official NPI Registry.