Individual provider Active NPI

Whitney Elizabeth Hicklin, APRN, FNP

  • Family Nurse Practitioner
  • Katy, TX
National Provider Identifier
1770131153
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1061718 Issued in TX
Practice address
24285 Katy Fwy Ste 300
Katy, TX 77494-1327
Phone
(818) 653-8290
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1061718 TX Primary
Registered Nurse 163W00000X 95162159 CA

Addresses

Primary practice location

24285 Katy Fwy Ste 300
Katy, TX 77494-1327

Mailing address

5148 Mockingbird LN
Katy, TX 77493-2128
Phone (818) 653-8290

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL gEHRiMed

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220528000045 TX Practitioner - Nurse Practitioner 7911385273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collaborative Geriatrics IncGroup PAC ID 5193827046, 45 clinicians

Practice addresses (Care Compare)

24285 Katy Fwy
Suite 300
Katy, TX 77494-1327
Phone (346) 387-7171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95162159CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Geriatrics Inc CurrentSince May 13, 2022 Accepting new patients

Locations

24285 Katy Fwy
Ste 300
Katy, TX 77494
Phone (346) 387-7171

1405 Valhalla Dr
Wharton, TX 77488
Phone (713) 723-9068

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.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1770131153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5148 MOCKINGBIRD LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932128",
            "telephone_number": "818-653-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941327",
            "telephone_number": "818-653-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "WHITNEY",
        "middle_name": "ELIZABETH",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1061718",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95162159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gEHRiMed",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "24285 Katy Fwy Ste 300",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774941327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.