Individual provider Active NPI

Nancyanne Page Hickman, P.T.

  • Physical Therapist
  • Southaven, MS
National Provider Identifier
1821474107
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP025394T Issued in MS
Practice address
7580 Clarington CV
Southaven, MS 38671-5657
Phone
(901) 259-1600
Fax
(901) 259-1698
NPI assigned
Aug 10, 2015
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10505 TN
Physical Therapist 225100000X CP025394T MS Primary

Addresses

Primary practice location

7580 Clarington CV
Southaven, MS 38671-5657

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5754
Phone (901) 725-8347

Other practice location 1

6286 Briarcrest Ave Ste 110
Memphis, TN 38120-4023
Phone (901) 259-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150922003033 TN Practitioner - Physical Therapist in Private Practice 4688981772 Reassigns benefits to 2 organizations
I20151208001796 MS Practitioner - Physical Therapist in Private Practice 4688981772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP025394TMSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Physical Therapist CurrentSince Aug 7, 2015 Accepting new patients
MSK Group, PC Physical Therapist CurrentSince Aug 7, 2015 Accepting new patients
Cairn Strength & Wellness LLC Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
MSK Group PC Physical Therapist CurrentSince Oct 19, 2015 Accepting new patients

Locations

7111 Southcrest Pkwy
Ste 105
Southaven, MS 38671
Phone (901) 261-2506

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

1350 Concourse Ave
Ste 363
Memphis, TN 38104
Phone (901) 260-6155

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 110
Memphis, TN 38120
Phone (901) 259-1600

794 S Cooper St
Ste 102
Memphis, TN 38104
Phone (901) 337-4316

Interoperability endpoints

  • Direct secure messaging: nancyanne.hickman.p6@direct.athleticoltd.nextgenshare.com

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, 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": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1821474107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715657",
            "telephone_number": "901-259-1600",
            "fax_number": "901-259-1698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6286 Briarcrest Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381204023",
            "country_code": "US",
            "telephone_number": "901-259-1600",
            "fax_number": "901-259-1698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "NANCYANNE",
        "middle_name": "PAGE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10505",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "CP025394T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.