Individual provider Active NPI

Heather Renee Hickman, CPNP

  • Nurse Practitioner
  • Rome, GA
National Provider Identifier
1922399286
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN194193 Issued in GA
Practice address
85 John Maddox Drive Connector NW
Rome, GA 30165-1233
Phone
(762) 235-2990
Fax
(706) 238-8031
NPI assigned
Apr 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN194193 GA Primary

Addresses

Primary practice location

85 John Maddox Drive Connector NW
Rome, GA 30165-1233

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Other identifiers 1

IdentifierTypeStateIssuer
003108522AMedicaidGA

Other names 1

  • Heather Renee Vanover Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heather.hickman.1@1498.direct.athenahealth.com

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN194193GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: heather.hickman.1@1498.direct.athenahealth.com
  • Direct secure messaging: hhickman3005001@carolinashealthcaresystem.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1922399286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 JOHN MADDOX DRIVE CONNECTOR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651233",
            "telephone_number": "762-235-2990",
            "fax_number": "706-238-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN194193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108522A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heather.hickman.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "85 John Maddox Drive Connector NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "VANOVER",
            "middle_name": "RENEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.