Individual provider Active NPI

Katherine Rebecca Hicks, DPT

  • Orthopedic Physical Therapist
  • Rincon, GA
National Provider Identifier
1780824698
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT009554 Issued in GA
Practice address
135 Goshen Road Ext
Rincon, GA 31326-5567
Phone
(912) 826-3797
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT020367 PA
Orthopedic Physical Therapist 2251X0800X PT009554 GA Primary

Addresses

Primary practice location

135 Goshen Road Ext
Rincon, GA 31326-5567

Mailing address

135 Goshen Road Ext
Rincon, GA 31326-5567
Phone (912) 826-3797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120920000231 GA Practitioner - Physical Therapist in Private Practice 3870741655 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

260 Peachtree St NW
Suite 2200
Atlanta, GA 30303-1292
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020367PAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation & Consulting Limited Partnership Orthopedic CurrentSince Jun 30, 2017 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Apr 11, 2022 Accepting new patients
Fox Rehabilitation Ga, LLC Orthopedic CurrentSince Jan 1, 2019 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Orthopedic CurrentSince Jun 30, 2017 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Apr 11, 2022 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Effingham Rehab Services, LLC Past Accepting new patients
Effingham Rehab Services, LLC Orthopedic Past Accepting new patients

Locations

7423 Adairsville Hwy
Adairsville, GA 30103
Phone (770) 373-9315

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

1000 Johnson Ferry Rd
Ste A115
Marietta, GA 30068
Phone (404) 367-2085

7 Carnegie Plz
Ste 110
Cherry Hill, NJ 08003

Organizations & group practices 9

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": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1780824698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265567",
            "telephone_number": "912-826-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265567",
            "telephone_number": "912-826-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KATHERINE",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT020367",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT009554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.