Individual provider Active NPI

Brittany Lashay Hicklen, NP-C

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1801596572
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
HICK-2NJDM Issued in NC
Practice address
3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone
(910) 945-9549
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X HICK-2NJDM NC Primary

Addresses

Primary practice location

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565

Mailing address

1209 Sweetgrass St
Knightdale, NC 27545-8162
Phone (704) 891-6459

Other identifiers 1

IdentifierTypeStateIssuer
1801596572OtherNCNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230522002485 NC Practitioner - Nurse Practitioner 6103282827 Reassigns benefits to 2 organizations

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
SNF Physiatry Services NC PLLCGroup PAC ID 1759805625, 12 clinicians

Practice addresses (Care Compare)

414 Fayetteville St
FL 4
Raleigh, NC 27601-1793
Phone (877) 544-4446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
HICK-2NJDMNCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Feb 7, 2023 Accepting new patients
Lifesource of North Carolina Nurse Practitioner CurrentSince Jun 12, 2024 Accepting new patients
Lifesource of North Carolina Nurse Practitioner CurrentSince Jun 12, 2024 Accepting new patients
SNF Physiatry Services NC PLLC CurrentSince Aug 28, 2025 Accepting new patients

Locations

414 Fayetteville St
Fl 4
Raleigh, NC 27601
Phone (347) 860-5351

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

1804 Forest Hills Rd W
Wilson, NC 27893
Phone (252) 237-8161

185 Route 70
Ste 302
Toms River, NJ 08755
Phone 7328130799105

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1801596572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 SWEETGRASS ST",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458162",
            "telephone_number": "704-891-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 RANDALL PKWY STE 105",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032565",
            "telephone_number": "910-945-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLEN",
        "first_name": "BRITTANY",
        "middle_name": "LASHAY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "HICK-2NJDM",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801596572",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.