Individual provider Active NPI

Deborah Renee Hickman, CNP

  • Pediatric Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1801842174
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CP000113 Issued in SD
Practice address
1600 W 22ND St
Sioux Falls, SD 57105-1521
Phone
(605) 312-1000
Fax
(605) 312-1001
NPI assigned
May 26, 2006
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 073137 IA
Nurse Practitioner 363L00000X R024346 SD
Pediatric Nurse Practitioner 363LP0200X CP000113 SD Primary

Addresses

Primary practice location

1600 W 22ND St
Sioux Falls, SD 57105-1521

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

4405 E 26th St
Sioux Falls, SD 57103-4136
Phone (605) 328-9080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dhickman5878@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20040519001453 SD Practitioner - Nurse Practitioner 5799776662 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073137IAMDNurse Practitioner
R024346SDMDNurse Practitioner
CP000113SDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Nurse Practitioner Current Accepting new patients
Sanford Medical Center Nurse Practitioner CurrentSince Nov 18, 2019 Accepting new patients
Sanford Clinic Nurse Practitioner CurrentSince Nov 22, 2009 Accepting new patients
Sanford Clinic CurrentSince Nov 22, 2009 Accepting new patients
Sanford Clinic Nurse Practitioner Current Accepting new patients
Sanford Health Network CurrentSince Jan 1, 2014 Accepting new patients
Sanford Medical Center CurrentSince Nov 18, 2019 Accepting new patients
Sanford Health Network Nurse Practitioner Past Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

1105 E Holly Blvd
Brandon, SD 57005
Phone (605) 582-5820

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

1600 W 22nd St
Sioux Falls, SD 57105
Phone (605) 312-1000

2601 S Ellis Rd
Sioux Falls, SD 57106
Phone (605) 312-3000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

6110 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 328-5800

Interoperability endpoints

  • Direct secure messaging: dhickman5878@direct.sanfordhealth.org

Organizations & group practices 10

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1801842174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "fax_number": "605-328-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051521",
            "telephone_number": "605-312-1000",
            "fax_number": "605-312-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4405 E 26th St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571034136",
            "country_code": "US",
            "telephone_number": "605-328-9080",
            "fax_number": "605-328-9081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "DEBORAH",
        "middle_name": "RENEE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "073137",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "R024346",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SD",
            "license": "CP000113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhickman5878@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1600 W 22nd St",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571051521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.