Active NPI
Robin L Hickerson, M.D.
- Child & Adolescent Psychiatry Physician
- Benton, AR
National Provider Identifier
1851379218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- C-6423
- Practice address
- 307 E Sevier St
Benton, AR 72015-3934 - Phone
- (501) 315-4224
- Fax
- (501) 778-0450
- NPI assigned
- Jan 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G6424 | AR | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | C-6423 | AR | Primary |
Addresses
Primary practice location
307 E Sevier St
Benton, AR 72015-3934
Mailing address
307 E Sevier St
Benton, AR 72015-3934
Phone (501) 315-4224
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114908001 | Medicaid | AR | |
| 116381726 | Medicaid | AR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| G6424 | AR | MD | Psychiatry Physician |
| C-6423 | AR | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Clinic, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Hot Springs, AR
- NPI 1578870663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583712000000",
"number": "1851379218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 E SEVIER ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720153934",
"telephone_number": "501-315-4224",
"fax_number": "501-778-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 E SEVIER ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720153934",
"telephone_number": "501-315-4224",
"fax_number": "501-778-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKERSON",
"first_name": "ROBIN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-05",
"last_updated": "2020-03-09",
"certification_date": "2020-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AR",
"license": "G6424",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AR",
"license": "C-6423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114908001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116381726",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.