Active NPI
Blaine Reuben Hickman
- Clinical Social Worker
- Layton, UT
National Provider Identifier
1881822716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 930 W Hill Field Rd
#A
Layton, UT 84041-4662 - Phone
- (801) 336-3040
- Fax
- (801) 336-3041
- NPI assigned
- Jun 30, 2009
- Last updated
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NU | Primary |
Addresses
Primary practice location
930 W Hill Field Rd
#A
Layton, UT 84041-4662
Mailing address
930 W Hill Field Rd
#A
Layton, UT 84041-4662
Phone (801) 336-3040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3390 W Signal Peak Dr
Suite 121
Taylorsville, UT 84129-3910
874 E 625
Layton, UT 84041-4300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LDS Family Services | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Taylorsville, UT
- NPI 1568250835
-
dba LDS Family Services wA Seattle Agency
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Renton, WA
- NPI 1073726485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1881822716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 W HILL FIELD RD",
"address_2": "#A",
"city": "LAYTON",
"state": "UT",
"postal_code": "840414662",
"telephone_number": "801-336-3040",
"fax_number": "801-336-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W HILL FIELD RD",
"address_2": "#A",
"city": "LAYTON",
"state": "UT",
"postal_code": "840414662",
"telephone_number": "801-336-3040",
"fax_number": "801-336-3041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "BLAINE",
"middle_name": "REUBEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.
- 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.