Individual provider Active NPI

Ryan-Niko Hickman, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1821224635
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19328 Issued in NV
Practice address
9320 W. Sahara Ave.
Las Vegas, NV 89117
Phone
(702) 383-3850
Fax
(702) 562-2816
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 321356 LA
Family Medicine Physician 207Q00000X 56829 AZ
Sports Medicine (Family Medicine) Physician 207QS0010X 39988 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 036.128902 IL
Sports Medicine (Family Medicine) Physician 207QS0010X 2011-00129 NC
Sports Medicine (Family Medicine) Physician 207QS0010X MD482065 PA
Sports Medicine (Family Medicine) Physician 207QS0010X 74809 MN
Sports Medicine (Family Medicine) Physician 207QS0010X 96415 GA
Sports Medicine (Family Medicine) Physician 207QS0010X 01091130A IN
Sports Medicine (Family Medicine) Physician 207QS0010X 3272-320 WI
Sports Medicine (Family Medicine) Physician 207QS0010X 2023031397 MO
Sports Medicine (Family Medicine) Physician 207QS0010X 077147 CT
Sports Medicine (Family Medicine) Physician 207QS0010X 25IA12394200 NJ
Sports Medicine (Family Medicine) Physician 207QS0010X C1-0027118 DE
Family Medicine Physician 207Q00000X 19328 NV Primary

Addresses

Primary practice location

9320 W. Sahara Ave.
Las Vegas, NV 89117

Mailing address

1800 W. Charleston Blvd. Ste. 508
Las Vegas, NV 89102
Phone (702) 383-2688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19328NVMDPharmacist
56829AZMDFamily Medicine Physician
077147CTMDSports Medicine (Family Medicine) Physician
C1-0027118DEMDSports Medicine (Family Medicine) Physician
96415GAMDSports Medicine (Family Medicine) Physician
036.128902ILMDSports Medicine (Family Medicine) Physician
01091130AINMDSports Medicine (Family Medicine) Physician
321356LAMDSports Medicine (Family Medicine) Physician
74809MNMDSports Medicine (Family Medicine) Physician
2023031397MOMDSports Medicine (Family Medicine) Physician
25IA12394200NJMDSports Medicine (Family Medicine) Physician
MD482065PAMDSports Medicine (Family Medicine) Physician
39988SCMDSports Medicine (Family Medicine) Physician
3272-320WIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Viewfi Health National Provider Services LLC Current Accepting new patients
Kingman Healthcare, Inc Family Medicine Past Accepting new patients

Organizations & group practices 2

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1821224635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W. CHARLESTON BLVD. STE. 508",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-383-2688",
            "fax_number": "928-263-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 W. SAHARA AVE.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "702-383-3850",
            "fax_number": "702-562-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "RYAN-NIKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "321356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "56829",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "39988",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036.128902",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2011-00129",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD482065",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "74809",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "96415",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01091130A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "3272-320",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2023031397",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CT",
            "license": "077147",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25IA12394200",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "DE",
            "license": "C1-0027118",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "19328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.