Individual provider Active NPI

Rebecca S Hickey, MS/CCC,SLP

  • Speech-Language Pathologist
  • Kokomo, IN
National Provider Identifier
1720283369
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22002463A Issued in IN
Practice address
700 E. Firmin Street
Suite 178
Kokomo, IN 46902-6403
Phone
(765) 203-1405
Fax
(765) 600-2199
NPI assigned
Jun 15, 2007
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22002463A IN Primary

Addresses

Primary practice location

700 E. Firmin Street
Suite 178
Kokomo, IN 46902-6403

Mailing address

1502 Tally Ho CT
Kokomo, IN 46902-4446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210325001478 IN Practitioner - Qualified Speech Language Pathologist 3375950017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22002463AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unlock Thetalk -SLP CurrentSince Oct 16, 2022 Accepting new patients

Locations

3541 S Lafountain St
Ste 5
Kokomo, IN 46902

700 E Firmin St
Ste 178
Kokomo, IN 46902
Phone (765) 203-1405

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1720283369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 TALLY HO CT",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E. FIRMIN STREET",
            "address_2": "SUITE 178",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026403",
            "telephone_number": "765-203-1405",
            "fax_number": "765-600-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "REBECCA",
        "middle_name": "S",
        "credential": "MS/CCC,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002463A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.