Camelia Hicks

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN205476 Issued in GA

Practice address

483 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-3717

Phone

(770) 787-3788

NPI assigned

Mar 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Restored Health Inc.

  • Family Medicine Physician
  • Lilburn, GA
  • NPI 1225242308
  Medicare reassignment NPD
• Asfc Outreach Therapeutic Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Covington, GA
  • NPI 1508051178
  NPD (past)

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1831621580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473717",
            "telephone_number": "770-787-3788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Chamblee Tucker Rd Bldg 16",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303414148",
            "country_code": "US",
            "telephone_number": "770-939-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "CAMELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN205476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melodie Anne (Or Desanto) Head
• Hear Better Holdings of Gwinnett
• Glenn Craig Heigerick, DO
• Rebecca Campbell Henderson, MSN, FNP-C
• Uyen Ho Hernandez, PHARMD
• Jerica Demetrus Hicks
• Steven Thomas Hightshue, PT, DPT
• Ebony Chanel Hill
• Farah Hindash, PHARMD
• Nguyen Ho

• Family Nurse Practitioner in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.