Individual provider Active NPI

Kathleen M Heckel Hicks, FNP-C

  • Family Nurse Practitioner
  • Chino Valley, AZ
National Provider Identifier
1780918037
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3460 Issued in AZ
Practice address
474 N Hwy 89
Chino Valley, AZ 86323-5993
Phone
(928) 636-5680
Fax
(928) 636-5853
NPI assigned
Sep 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP3460 AZ Primary

Addresses

Primary practice location

474 N Hwy 89
Chino Valley, AZ 86323-5993

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
983442MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100820000196 AZ Practitioner - Nurse Practitioner 1850425208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

474 N Hwy 89
Chino Valley, AZ 86323-5993
Phone (928) 636-5680

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Oct 8, 2018 Accepting new patients
Mikrut Physical Therapy LLC Past Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

474 N US Highway 89
Chino Valley, AZ 86323
Phone (520) 636-4355

1000 Willow Creek Rd
Ste B
Prescott, AZ 86301
Phone (928) 778-0330

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780918037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 N HWY 89",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235993",
            "telephone_number": "928-636-5680",
            "fax_number": "928-636-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKEL HICKS",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983442",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Valley, AZ

Sources for this page

Verify at the official NPI Registry.